Pamela Hill Institute

In a modern plastic surgery practice the role of the aesthetician is that of a collaborative professional.  Like the physician, the aesthetician is there to serve the patient and is an integral part of both the preoperative and postoperative care regimen.  The aesthetician helps to prepare the patient for surgery by offering medical spa treatments, is able to enhance the healing process and helps ensure that the patient is happier than otherwise.

The aesthetician should be  well qualified professional who goes above and the beyond the normal call of duty in skin care, assisting the physician in the outpatient surgery center, hospital, clinic or medical spa. Plastic surgeons look upon aestheticians as integral parts of the practice providing a key service.  Many studies indicate that in the unfortunate event that complications arise the patient will be less likely to litigate if he or she has been supported in the process through the use of aestheticians and other processionals.  Part of the job of the aesthetician is to provide TLC – tender loving care to the patients who are nervous or anxious or worried about their procedures.  The aesthetician also provides education to the patient about proper skin care, the place where it all begins, and this will help in the healing process.

A medical esthetician will be presented to the patient as the consummate skin care authority in the doctor’s office.  In addition to traditional medical support, services provided to the patient b the esthetician should include clinical skin treatment both pre and post operative; home skin care maintenance; post surgical camouflage makeup to hide bruising and make the patient less self-conscious; preoperative and post operative lymphatic massage therapy, both body and facial; and nutritional guidance.

Of course the medical aesthetician should be familiar with the patient’s skin type and their history, as well as being knowledgeable of facial ultrasound treatments, microdermabrasion, chemical and bioactive peeling agents, and aesthetic procedures. Providing patient education prior to surgery is critical and should start with the beginning spot for facial rejuvenation, the skin.  The skin contains several cell types including  melanocytes, fibroblasts, keratinocytes, immunocompetent, migrating mononuclear cells, and mastocytes.  The skin also contains connective tissue rich in extra cellular matrix, which is responsible for the reheological properties of the skin including mechanical resistance, suppleness and elasticity.  Other components include hydratin, thermoregulation and permeability regulation.

Peels and ultrasonic treatments performed by an aesthetician before facial rejuvenation stimulate cell proliferation and enhance the integrity of the skin’s internal structure and external texture. Alphahydroxy acid peels increase the synthesis of collagen, proteoglycans and glycosaminoglycans such as hyaluronic acid.  Through a thorough professional knowledge, proper treatment, and patient education the aesthetician in a plastic surgeon’s office contributes to patient satisfaction and to a positive outcome of the procedure.

Microdermabrasion is a wonderful treatment for many patients, providing an opportunity to rid a client of the outer layer of skin, dead skin, and bring to light the fresh, youthful appearing skin beneath. It is accomplished through many different methods including mechanical abrasion from jets of zinc oxide or by aluminum oxide crystals. Clients best suited for microdermabrasion are those who have sun damaged skin, dark skin spots, acne scaring or rough skin that can be helped through the process.

The darker a client’s skin, the better suited they are in general for the microdermabrasion process. Those clients who have extremely light or fair skin, and especially those with freckles, need to avoid exposure to the sun afterwards.  

Fortunately for those who need microdermabrasion it is a safe procedure that requires no anesthetic. It works best in removing scars that are level with , or above skin level and not as well with sunken scars. For treatment of acne it is effective but the process needs to be repeated periodically. It is very important that those who have taken the medication Accutane, or Isotretinion in the previous 12 months avoid microdermabrasion as it can cause complications.

When microdermabrasion came to the United States in the 1990’s it was quickly adopted for use by many spas. It was found to work effectively with clients who have fine wrinkles, stretch marks and moderate scares. Of course, clients should be in good health, should have reasonable expectations, and should understand the sun avoidance that is recommended. Microdermabrasion has become one of the most popular treatment methods in the United States. In 2005 for instance it was one of the top five procedures with almost 150,000 performed. This is an increase of twenty-six perform from just two years earlier. Microdermabrasion by the way was developed in 1985 in Italy and quickly spread throughout Europe, being a successor to the outer lay of skin removal methods that date back to 1500 BCE in Egypt, when a sandpaper method was used to remove scars. In the 1800’s dermabrasion, a cousin that is more invasive, was introduced in Europe using human powered machines, eventually replaced by wire brush devices. Dermabrasion however can be painful, has a long down time for recovery and requires anesthesia, as well as having the possibility of infection, so many people consider microdermabrasion to be a step forward.

The Plastic Surgery guide provided by PreferredConsumer.com is a collection of information, articles and news related to all areas of  Plastic Surgery.  Learn about the latest plastic surgery Aesthetic Trends today.   From Plastic Surgery procedures to Dermatology to weight loss surgery.  You may also find several types of medical services, including Plastic Surgeons, Dermatologists, Ear, Nose and Throat (ENT's), Cosmetic Laser Centers and Medical Spas. For more detailed information on plastic surgery procedures click on one of the plastic surgery procedure links below.

Abdominoplasty Plastic Surgery

Abdominoplasty, also known as a "tummy tuck," is a plastic surgery procedure to remove excess skin and fat from the abdomen and to tighten the abdominal muscles. Though the procedure reduces abdomen size, it does produce a permanent scar. In extensive cases, the scar can extend from hip to hip.

Breast Augmentation Plastic Surgery

Breast augmentation is a plastic surgery procedure that enlarges the size and shape of a woman's breast. The procedure is done for the following reasons:

    * To increase the breast size in a woman who feels her breasts are too small
    * To correct reduced breast size after pregnancy
    * To make breasts "match" each other
    * To reconstruct the breast following breast surgery

Surgeons are able to increase a woman's bustline by one or more bra cup sizes.

Chemical Peel

Chemical peel uses a chemical solution to remove damaged outer layers of the skin, resulting in a smoother appearance. The procedure is done to improve the appearance of facial blemishes, wrinkles, and uneven skin pigmentation. The chemical solution is adjusted to meet each patient's needs. Phenol, trichloroacetic acid (TCA) and alphahydroxy acids (AHAs) are the common chemicals used. A chemical peel may be performed in combination with other facial plastic surgery methods.

Eyelid Plastic Surgery

Eyelid surgery is a plastic surgery to remove fat and excess skin from the upper and lower eyelids. It is also known as Blepharoplasty.  Drooping upper lids and puffy bags below your eyes can make you look tired and older; eyelid surgery can minimize this problem.

Facelift Plastic Surgery

A facelift improves the signs of aging by removing excess fat, tightening underlying muscles, and redraping the skin of your face and neck. A facelift can be done alone, but it is often done with other types of facial plastic surgery.

Liposuction Plastic Surgery

Liposuction is a plastic surgery procedure that sculpts the body by removing unwanted fat from specific areas. The procedure has been greatly improved during the past decade. Today, many new techniques, including ultrasound-assisted lipoplasty (UAL), the tumescent technique, and the super-wet technique give patients better results with faster recovery times.

Rhinoplasty Plastic Surgery

Rhinoplasty is one of the most common of all plastic surgery procedures that can change the shape and/or size of the nose. This procedure can also be used to correct injuries, birth defects, and breathing problems.

Cosmetic Ear Surgery

Cosmetic ear surgery is done to set prominent ears back closer to the head or to reduce the size of large ears. The best time for the operation is when children are between the ages of four and 14; ears are almost fully grown by age four. Ear plastic surgery can also be done for older adults.

Sclerotherapy

Sclerotherapy is a method used for removing spider veins and larger varicose veins. Spider veins are small clusters of red, blue, or purple veins that most commonly appear on the thighs, calves and ankles. The procedure involves injecting the veins with a sclerosing solution, causing them to collapse.

Dermabrasion

Dermabrasion and dermaplaning help to renew the skin's top layers through controlled surgical scraping and sanding. This gives the skin a smoother appearance by scraping away irregularities. The procedure can also be used to remove pre-cancerous growths, improve scarring, and minimize wrinkles. These procedures can be used alone or in combination with other facial plastic surgery methods.

Reprinted fin part rom SpaFinder.com - a great resources for spa and medical spa professionals. 

Improved administration of Botox can create business issues that you just don’t want to have to deal with.  Proper use of Botox during treatment is imperative since the overuse or improper use can lead to the 'frozen face' syndrome and effectively kill your medical spa business. Word spreads fast and with the immense popularity of Botox, it can hurt a business quite badly if used improperly and help to skyrocket a business to success if the business has a reputation for doing Botox  properly each and every time.

Botox is Exceptional When Administered Properly by a Trained Professional

First used in 1978 to weaken overactive eye muscles, Botox has gained in popularity in cosmetic used and since 1990 has been quite popular for use in getting rid of facial wrinkles that come from muscle contraction. These include forehead lines, crow’s feet and frown lines.  It is popular and it works but many people jump into it a bit too quickly, and some have misused it.  The effects from Botox injected into the muscles last for three to four month.  Loosing frown lines is great, but clients should carefully avoid losing all expression on the face and a clinician should work with the client to pick and choose injection sites very carefully.

Less is Always More with Botox

One mistake that clients make is trying to look like their favorite movie star or a rock idol they have.  The problem of course is that everyone’s face is different, and trying to look too much like someone else can lead to overuse of Botox.  Just try to look like the best “you” that you can be.  Talk to your clients openly and honestly about what you can do to help using Botox and what you cannot do. Gently convey to your clients that a face is designed to show expression and Botox should be used in moderation to help combat aging. 

Remember that Botox is a Toxin

Remember that Botox is manufactured from a neurotoxin. One of the miracles of modern medical science is that something that once would have been considered something to be avoided is now the most common anti aging treatment practiced in the western world.  But the old saying “less is more” is often quite true with Botox.  It is a powerful agent and small amounts can make a world of positive good in your appearance while too much can be a negative.  Talk to your patients so they are aware that you are a professional with high ethical standards, and that Botox should not be overused. A little openness and education with your patients up front can do a lot for your business - by enhancing your clients expectations and level of satisfaction, improving your client base through word of mouth advertising and by establishing your firm position as an ethical medical spa clinician.

This is Day 2 in our Week of Guest Speakers for the Benefit of all the Spa Professionals and Aestheticians that turn to us for ongoing industry education. We hope our special guest articles teach, motivate and inspire you!

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Why is it called plastic surgery?  The word plastic comes to us from the Greek word plastikos which means to mold or shape.”  Many of the early plastic surgery procedures were performed to close difficult wounds for war casualties or serious illness. Replacing tissue lost due to an injury or to cancer, these procedures often involved formation of a skin flap to mold or reshape the defect to approximate the original shape, so even though no plastic is used, the word plastic seemed appropriate.

Reconstructive and Cosmetic Surgery: The Difference

Another interesting question people often ask is what is the difference between cosmetic surgery and reconstructive surgery?  Both are in the realm of plastic surgery.  Cosmetic surgery procedures are performed to reshape structures of the body to improved the appearance and self-esteem of the patient.  For that reason cosmetic surgery is considered elective and is usually not covered by the patent’s insurance.  Reconstructive surgery is performed to repair abnormal structures of the body. These may be caused by developmental abnormalities, trauma, infection, congenital defections, tumors or disease. Health insurance usually covers reconstructive surgery.  Then there are the gray areas that require special consideration by the insurance company. The patient’s condition can determine whether or not some procedures are actually reconstructive or cosmetic.  Eyelid surgery for instance usually is performed for cosmetic improvement, but it can be considered reconstructive if the eyelids are drooping severely and causing vision obstruction.

The Romans and Ancient Indians Performed Plastic Surgery

Most of us think of plastic surgery as just being part of the modern world, but it actually dates back many centuries.  In ancient India skin grafts were used for reconstruction.  Also the Romans repaired damaged ears of soldiers injured in battle. But what we think of as modern plastic surgery had to await the arrival of anesthetics before it began to be practiced widely, and that was primarily inspired by war.

Wars Created Plastic Surgery Advances

One  of the pioneers in America of plastic surgery was Dr. John Peter Mettanuere, who performed a cleft palate operati