Blog

Today’s skilled cosmetic plastic surgeon knows that getting the best results from any cosmetic operation requires a customized surgical plan for each patient. Facelift surgery is particularly challenging, since patients differ widely in their underlying facial structure as well as the extent of their visible aging. According to an article in the The Aesthetic Society (formally the American Society for Aesthetic Plastic Surgery – ASAPS) publication, Aesthetic Surgery Journal, there are at least ten important considerations in designing a great facelift. If patients are aware of the process their plastic surgeon goes through to develop a surgical plan, they can be more active participants in some of these decisions.

A well-designed facelift will take into account factors including:

1. Hairline Position. A small shift in the position of the hairline is considered acceptable and usually is not noticed, but patients starting out with an elevated hairline position may need special techniques to avoid raising it further.
2. Incision Placement. Many patients and their friends judge the success of a facelift on the basis of minimally detectable scars. Where to place incisions depends on factors such as the amount of excess skin and whether the patient has pre-existing creases in front of the ears.
3. Cheek Volume. If the cheek area appears flat because of inadequate bony projection, sometimes the use of fat injections or implants may provide better definition.
4. Fat Pad. In rare instances, a herniated or prominent buccal fat pad, located in the cheek area, may need to be removed or sutured at a deep level.
5. Cheek Folds. Cheek, or “nasolabial” folds are difficult to treat, but a facelift that pulls in a vertical direction will help to restore sagging soft tissue to its natural position in the cheek area. Injection with a soft tissue filler, such as fat, may also be necessary to achieve optimal results.
6. Jaw Line. Jowls are caused by sagging soft tissue that must be elevated. If excess fat is present, it may be removed by suction (lipoplasty).
7. “Trough.” There is a region defined by the angle of the jaw where it interfaces with the neck that is called the ‘trough’. A shallow trough gives the face a rounder look, whereas a deeper trough contributes to a more chiseled look generally associated with youth and attractiveness. When necessary, defatting this area may give it better definition.
8. Chin. The profile of the chin plays an important role in an attractive appearance. An overly prominent chin, “weak” chin, “double chin” or “witch’s chin” all can be addressed with additional procedures performed at the same time as a facelift.
9. Glands. Sometimes the glands located in the neck, underneath the chin, appear prominent and can detract from the neck’s appearance. While most patients find some fullness in this area acceptable, surgical removal or repositioning of the glands is an option, though not without risks.
10. Neck Cords. If neck cords appear prominent from the frontal view, correction may require a small incision underneath the chin, nearly undetectable when healed.

“The very best results in our patients are achieved when we match what facial cosmetic surgery can give them with their realistic expectations.” Our team listens very closely to what you want and suggests positive ways to reach the appearance that you desire. He specializes in giving you “not extreme” just “natural” results.

“Because there are things women need to know about breast implants and augmentation”

Myth 1: “Everyone will know that I have these breast implants.”
Most implants which are obvious to the casual observer are due to avoidable problems: the implants are placed too high, are inappropriately in front of the chest muscle, or are too large for your chest. A carefully planned and performed breast enhancement can give most patients a very lovely, natural appearing result. Be sure to choose an experienced surgeon who will consider your desires while taking into account your height, weight, and your natural breast size, shape, and symmetry. Choosing an appropriate implant shape and size and positioning it correctly are key to achieving a natural looking result. Often, lifting your nipple and areola slightly can greatly enhance your result.

Myth 2: “Implants must be replaced every 5 to 10 years.”
Implants do not need to be replaced unless a problem occurs. Many patients have had implants for 20+ years, which continue to be soft and natural looking. With the saline filled implants currently used for most patients desiring larger breasts, the most common problem is leakage. But less than 1% of our patients have had leaks in 14 years! While implant deflation is not dangerous, the failed implant must be promptly removed and replaced. Interestingly, the most common cause for implant removal and exchange is the patient’s desire to have larger implants! And the most common cause for reoperation is asymmetric implant positioning.

Myth 3: “I will have to change my lifestyle or activities.”
Prior to surgery, we will give you guidelines concerning the time needed off from work, and how soon you may expect to resume your particular sports and hobbies. Once healing has taken place a patient may resume all of her usual activities. Your surgeon will guide you during the initial weeks of healing. Ultimately, you can scuba dive, mountain climb, parachute jump, kick box or anything else that you might desire without worrying about your implants. Breast implant placement may slow times in swimming competition.

Myth 4: “A large enough implant will correct “droopy” breasts.”
If you have droopy breasts, that is, if your nipples are at or below the bottom of your breasts, implants alone will not correct the problem. Implants will increase the size of your breasts, but the nipples will still be too low and your breasts will not look attractive. You will need a lift procedure along with your breast augmentation to achieve a well-shaped breast. The type of lift needed will depend on the amount of drooping present. Your surgeon will discuss the various options with you. Some patients who are satisfied with the size of their breasts, but have lost shape due to pregnancy or weight loss, will find that a lift alone will solve their problem.

Myth 5: “Implants will feel unnaturally firm.”
While augmented breasts will never feel as completely soft as most natural breasts, breast implants are a very good substitute. The key is to prevent, as much as possible, the building up of scar tissue around the implant. While no one has a magic formula to prevent this entirely, there are things that can be done to reduce the chances of having significant encapsulation occur. There are some convincing studies showing that textured saline implants are less likely to develop thick scar capsules than smooth wall implants. Placing the implants under the chest muscle helps to keep them feeling soft, and minimizes visible rippling. Using implants that are not too large and fit comfortably on the chest wall are other factors affecting firmness. It is important to follow your surgeon’s directions to achieve the best possible outcome.

Whether you choose to have facial rejuvenation with laser treatments, fillers and muscle relaxants, massage or Endermolgie cellulite reduction or Endermolift non-invasive “face lift”, sclerotherapy and laser leg spider vein treatment, the latest and most effective advanced medical skin care with microdermabrasion and lunchtime peels, or the latest most effective LightSheer laser hair removal, we have it all. This is one of the only area Medispas where all facial and Botox^® Cosmetic treatments are done directly by our plastic surgeon. Your non-invasive facial rejuvenation will benefit from his artistry and over 22 years of experience as a cosmetic plastic surgeon. We also are one of the only medispas to have a plastic surgeon on-site as the medical director to address your every need.

Mrs. New York answers the door of her Gansevoort home and, of course, she is attractive, but she may be a little overdressed for a casual interview in her kitchen.

Read Full Story.

Dr. Yarinsky was featured in an article in the Post-Star on Botox! Click here to read the article! (PDF)

September 8, 2009 – Saratoga Springs Plastic Surgery, PC has earned The Joint Commission’s Gold Seal of Approval™ for the third time since 2003 by demonstrating compliance with The Joint Commission’s national standards for health care quality and safety. The Joint Commission reaccredits medical practices every 2-3 years. “Saratoga Springs Plastic Surgery, PC stands alone as the only Joint Commission accredited office based surgery center in the Capital District,” says medical director Steven Yarinsky, MD.

“Saratoga Springs Plastic Surgery, PC underwent a thorough on-site evaluation against nearly 150 standards that promote quality care and patient safety,” says Michael Kulczycki, executive director, Ambulatory Care Accreditation Program, The Joint Commission. “Their decision to pursue this voluntary process demonstrates their commitment to provide the highest quality care in a safe office environment.”

Dr. Yarinsky performs all facial and body contouring cosmetic surgery procedures at his office facility. “Our patients love the privacy, safety, comfort and state-of-the-art care we provide. Our surveys confirm that patients prefer our office facility setting for their cosmetic procedure,” Yarinsky emphasizes. Nationwide, the number of surgical procedures performed in physician offices and ambulatory surgery centers surpasses those performed in hospitals. However few offices providing surgery services have achieved Joint Commission accreditation. The Joint Commission has more than 50 years’ experience as the nation’s leading evaluator of patient safety and quality service in health care organizations.

Steven Yarinsky, MD says achieving Joint Commission accreditation was a team effort. “Every employee has an important role in making sure we provide the best care possible,” he says. “The educational experience the surveyors provided was invaluable to us. My staff and I have always been dedicated to providing every patient we see with an exceptional level of quality service and care to achieve the best possible results. Joint Commission accreditation confirms that we provide high quality and safe medical care.”

Although Saratoga Springs Plastic Surgery, PC has been continuously accredited since 2003, as of July 2009 the New York State Department of Health now mandates that all medical practices that provide in-house surgical services be accredited.

Click here for more information about JCAHO.

What’s hot this spring? The bathing suit catalogs have arrived. Many American women and men are busy seeing their plastic and cosmetic surgeons to enhance their bodies to look better in spring and summer fashions! There are many safe and effective ways to beautify your appearance. And best of all, the results help you feel better about yourself. “Looking and feeling your best” took on new meaning with the results of a study published in the January/February Aesthetic Surgery Journal. The article entitled “Better Sex from the Knife? An Intimate Look at the Effects of Cosmetic Surgery on Sexual Practices” shows that there are physical and emotional benefits to cosmetic surgery “Cosmetic surgery patients overwhelmingly tend to feel better about their body” after breast enhancement with augmentation and lifts, liposuction of the thighs, and tummy tucks. The majority of women surveyed found that their sex lives and those of their sexual partners were “strikingly enhanced” after their breast or body contouring cosmetic procedure, giving them “a significant quality of life benefit”!

If you choose cosmetic surgery to enhance your appearance or feel better about your body, you are certainly not alone. Cosmetic Surgery Statistics from The Aesthetic Society (formally the American Society for Aesthetic Plastic Surgery – ASAPS) released two weeks ago show that there were 2.1 million cosmetic surgeries and 9.3 million nonsurgical procedures done in the United States in 2005. The most popular cosmetic procedures are liposuction, breast augmentation and lift, eyelid surgery, nose reshaping and tummy tucks. The most common nonsurgical cosmetic procedures include Botox^®, laser hair removal, facial fillers like Restylane, microdermabrasion, and chemical peels. Since 1997 the number of cosmetic procedures performed has increased 222%. Almost 50% of all cosmetic procedures in 2005 were done in office-based facilities. Another recent Aesthetic Society survey shows that cosmetic surgery is now approved by the majority of people and that patients are no longer “embarrassed” by others knowing that they had it done.

Nationwide there are so many physicians who are not trained in plastic surgery doing cosmetic surgery, that now it is more important than ever to be careful when choosing your plastic surgeon. The New York Times February 16, 2006 story “Beauty on the Black Market” reports the risks and poor results seen when patients choose an unlicensed or inexperienced practitioner for their “beauty treatment”, which is often done without medical supervision in a shopping mall, beauty salon, health spa, or in their homes. The Capital District has many nonmedical personnel performing medical cosmetic procedures, such as chemical peels, microdermabrasion and laser hair removal in non-clinical settings which lack physician supervision. There are also several local physicians who are not board-certified in dermatology or plastic surgery who have set up centers to do laser hair removal, laser face treatments, tissue filler injections, and Botox^® treatments. The explosive growth of the lucrative yet poorly regulated cosmetic enhancement marketplace emphasizes the importance of “buyer beware”. For safety’s sake, all cosmetic procedures including those that are nonsurgical should be done in an appropriate facility under the supervision of a well-trained and experienced physician.

Steven Yarinsky, MD is a board-certified plastic surgeon who has been in practice at Saratoga Springs Plastic Surgery, PC since 1989. His role as a local Ambassador for the American Society of Plastic Surgeons is to educate the public about the value and safety of choosing a board certified plastic surgeon for their cosmetic surgery needs. Whether you are interested in laser wrinkle removal, facial, body contouring or breast cosmetic surgery, or non-invasive procedures such as Botox^® injections, laser leg vein, face capillary (rosacea) and hair removal, sclerotherapy spider vein therapy, Endermologie cellulite treatment, therapeutic massage, and state-of-the-art physician directed skin care, our team offers you the full range of cosmetic rejuvenation and cosmetic surgery options.

Although many plastic surgeons offer “cosmetic seminars” to the public, Dr. Koumanis’ patients find that their most rewarding educational option is to meet him for a one-on-one consultation. He recommends that a friend or family member accompany you. Choose a plastic surgeon like Dr. Koumanis who is certified by the American Board of Plastic Surgery. Be sure that you find a plastic surgeon who you trust and understand, who is an expert in doing your desired procedure. Do your homework and learn about the benefits and risks of the procedure you want. Be realistic about what result is possible to achieve. Talk to people in Dr. Koumanis’ cosmetic patient phone referral network who have had the procedure you desire so you know what to expect. Share your entire medical history with your plastic surgeon. Be sure all of your questions have been answered before you proceed. Then save or finance, if needed, to have the procedure done. While it is tempting to “bargain shop”, your surgeon’s training and experience are the most important factors in obtaining a successful result. Do not compromise when it comes to your face or body.

Dr. Koumanis offers all cosmetic services and surgery at the only JCAHO office-based surgery center in the entire Capital District, Saratoga Springs Plastic Surgery, P.C. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) is the organization that accredits hospitals across the United States. Accreditation by JCAHO is considered the “Gold Standard” for safety and excellence in health care, and has been achieved by only a fraction of the office-based facilities nationwide. Dr. Koumanis’ exclusive center for excellence provides you with the highest quality cosmetic surgery services and the ultimate in continuity of care, delivered in a warm, comfortable, and confidential environment. People recuperate in the comfort of their home. Dr. Koumanis and his caring staff feel that every person they see has unique desires and needs and deserves individualized and special treatment. Our team has grown our practice by over-exceeding patients’ expectations. There is no longer a need to go to Beverly Hills or New York City to find an expert for your cosmetic surgery needs. Call us at (518) 583-4019 weekdays for information and an appointment. You, too, can look and feel your best!