The Science & Benefits of Your Smartlipo™ Treatment

Dr. Kevin Johnson explains Smartlipo™ offered at his cosmetic surgery practice in Spokane.

One of the most popular cosmetic surgery treatments at my Spokane and Coeur d’Alene practices is Smartlipo, or laser-assisted liposuction. This body contouring procedure can help to smooth curves and reduce hard-to-treat areas of fat that are often found in the lower abdomen, back, flanks, hips, arms, and thighs. You can learn more about the process involved in the procedure on the liposuction treatment page.

While before-and-after images of Smartlipo patients tell part of the story, it’s also important to understand the scientific explanation behind the treatment. To help explain those details, here are some of the features involved in this laser-assisted treatment and the benefits behind each.

The Narrow Cannula

A major benefit of Smartlipo is that no major incisions are required to perform the treatment. The treatment uses a thin metal cannula, or tube, which houses the laser fiber. It’s about 1 millimeter wide. This cannula is inserted into the body through small incisions that are only slightly wider than the cannula itself, between 3 and 5 millimeters. These incisions can be placed in areas where folds already exist, such as the navel or below the pant line, so they will be easily disguised.

In the before-and-after images below, you can see the patient’s incisions, indicated by the small red dots on either side of their lower abdomen. The incisions are small, they will heal quickly — and with the proper care, the scars will fade.

See before-and-after images from cosmetic surgery patients in Spokane.

The Multifunctional Laser Fiber

Once inserted, the laser fiber performs a number of actions at once. First, it targets the fat cells, rupturing and liquefying them. It simultaneously cauterizes blood vessels and coagulates blood in the treated area, which reduces bleeding. After the fat in the treated area has been prepared for removal, the cannula is attached to a suctioning device, which vacuums those melted fat cells out.

The Recovery

Smartlipo is an outpatient procedure which uses a local anesthetic, so patients may stay awake during the treatment and return home immediately after. Some discomfort and soreness are normal for a day or 2 following the surgery, but patients can generally return to their normal routines quickly.

The Long-Term Results

When the laser destroys and removes the fat cells in the treated area, the patient’s body recognizes that the fat has been removed and begins to restore the healthy cells around the treated area. This produces collagen, which in turn encourages elasticity and tightening of the skin and underlying tissue. Because of this, many patients have improved skin tone in the treatment area, which develops in the days and weeks following the procedure.

Have more questions about Smartlipo? Feel free to leave them in the comment section below. You can also visit my liposuction FAQ page for answers to some other common questions.

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The FAQs About Dermal Fillers: Cost, Ingredients, and More

Get FAQs about dermal fillers from cosmetic surgery doctor in Spokane.

Hollow cheeks, thinning lips, bags under the eyes — we’re all familiar with the common signs of aging that nearly everyone experiences. And while facelifts and other surgical procedures are solutions for some people, there are nonsurgical treatments that can be just as effective for many people. Some of the most popular options are dermal fillers. And while I know how exciting the results of these treatments can be, many first-time patients at my cosmetic surgery practice in Spokane have mentioned feeling hesitant to try them simply because they didn’t know enough about them. To help educate and inform my patients, I’m sharing answers to some of the most common questions I hear during consultations for dermal filler treatments.

How long do dermal fillers last?

The results of dermal fillers can last anywhere from 6 months to 2 years, depending on the area treated, the amount used, and the way your body interacts with the substance. With increased use, many patients find they need less frequent treatments. This is because the presence of the filler increases the production of collagen in the treated areas, so the body begins to produce added volume naturally.

What can dermal fillers really fix?

Dermal fillers are used in cosmetic treatments for a few reasons. Most notably, they can be used to fill deep facial creases and expression lines that are caused by wrinkles and repeated facial movements. Fillers are especially useful for camouflaging jowls and sharpening the jawline. Fillers are popular options for restoring volume in areas that have lost it over time, including the cheeks and under-eye areas. Younger patients often rely on fillers to add volume to their lips for a voluptuous look. In the before-and-after photos below, we used fillers to smooth out the patient’s under-eye bags. This gives her a more refreshed, rejuvenated look overall.

See before-and-after images from dermal filler patients from our cosmetic surgery practice in Spokane.

Fillers can also be combined with other treatments, like BOTOX® Cosmetic or Dysport® (a combination known as a liquid face lift) and skin resurfacing for even more impressive results.

How much do dermal fillers cost?

At our practice, we price dermal fillers by the syringe. Depending on the area being treated, we may use anywhere between 1 and 4 syringes in a single treatment. For example, at my cosmetic surgery practice in Spokane and Coeur d Alene, Restylane® and Restylane Silk are $500 per syringe. Restylane Lyft is $550. Each of these fillers is FDA-approved for use in different areas of the face. This means that Restylane and Restylane Silk may be used on the lips, tear troughs under the eyes, and fine lines anywhere, whereas Restylane Lyft can be used in the cheek area, the temples, marionette lines, and along the jaw in the prejowl sulcus. During a consultation, we’ll be able to tell you which areas can benefit from which fillers, as well as how many syringes we’ll need to use.

How are dermal fillers administered?

Dermal fillers are exclusively injectable, so they’re administered through a tiny needle placed just under the skin. Most patients say they only feel a small pinch with each injection.

What qualifies a person to administer fillers?

The qualifications required to administer dermal fillers vary by state. Here at our practice, I am able to administer them, as is my aesthetic nurse, Brittany. Brittany is also a medical aesthetician, cosmetic laser trainer, and injection specialist. She has been expertly trained to administer these treatments and can provide patients with natural-looking results safely and efficiently. We’re proud of our extensive experience with injectables, and we’re one of the top 100 providers of Restylane Lyft in the nation!

What are dermal fillers made of?

Most dermal fillers use a gel formulation of an active ingredient called hyaluronic acid. This acid occurs naturally in our bodies and works to hydrate our connective tissues, joints, and eyes.

What happens after a treatment?

After your injections are over, you may see some minor swelling and tenderness in the treated area, though this will only last for a day or 2. You should avoid exercising, performing heavy lifting, or applying pressure to the treated areas immediately after your treatment. Besides those minor restrictions, you can return to your normal daily routine the next day.

If you’ve been considering dermal fillers but aren’t quite sure if they’re the right treatment for you, I encourage you to take a peek at our treatment guide. This tool helps you determine the treatments that may best fit your needs, based on the cosmetic concerns you have. Or, request a complimentary consultation so we can discuss your concerns together and determine if you’re a candidate for filler treatments.

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What Makes a Good Candidate for Smartlipo™?

A liposuction surgeon in Spokane shares qualifications for Smartlipo™.

Before scheduling a consultation or talking to a cosmetic surgeon, many people seeking a cosmetic treatment such as liposuction will first try to figure out on their own whether they’re a candidate for the procedure. Most of the time, a person’s candidacy for a treatment can be determined only through discussion and examination during an in-office consultation at my Spokane or Coeur d’Alene offices. However, there are a few guidelines that I always consider. While these points aren’t the only factors, they do help to guide our discussion and simplify the decision.

If you find the following statements to be true, you may be a good candidate for Smartlipo liposuction.

You have areas of fat that do not respond well to normal diet and exercise.

Smartlipo is not a weight loss procedure. It does, however, remove unwanted areas of fat. Often, the fat in areas including the flanks, upper and lower abdomen, arms, and thighs does not respond well to diet and exercise, no matter how much time you spend at the gym. Smartlipo can be an effective solution for these areas.

You do not have excessive loose skin.

Smartlipo is great for treating unwanted fat. And, it has the added advantage of tightening skin as well as creating shorter recoveries by decreasing bleeding and swelling. However, there is a limit to how much skin any laser can tighten. If you have experienced massive weight loss and have significant thinning, loose skin in the area you want to target, or you have significant abdominal wall muscle weakening you may have better results from a different type of body contouring procedure, such as a tummy tuck. This procedure repairs weakened muscles and removes larger areas of fat and excess skin. During a consultation at my Spokane or Coeur d’Alene office, I can help you determine which treatment is best.

You can see in the before-and-after pictures below that this patient has some stretch marks, but does not have excessive skin on her lower abdomen, but does have excess fat across the entire area. The Smartlipo treatment produced a smooth, more toned abdominal area.

See before-and-after pictures of liposuction in Spokane.

You can take a few days to rest after the procedure.

Smartlipo is less invasive than abdominoplasty (tummy tuck), but it still requires a few days of rest and recovery. Most patients take about 2 days off work to ensure they’re fully recovered and comfortable. You’ll still experience some swelling and soreness for a few weeks after the surgery, so it’s best not to plan the surgery immediately before any major events or vacations.

You are in good general health.

As a medical doctor and surgeon, I always put your health and safety first. It’s important that your body is strong and healthy enough to undergo a Smartlipo surgery and make a swift, successful recovery. The procedure requires local anesthesia and prescription or over-the-counter pain medication for recovery. Plus, I encourage you to maintain an active lifestyle and healthy diet after your surgery to maintain your results. We call it “protecting your investment.”

You have realistic expectations.

Everyone’s body is different, and everyone’s results are equally unique. While I can’t make you look like someone you aren’t or turn back the hands of time, I can help you achieve the best contours and shape possible at the time of your surgery. During our consultation, we discuss your goals in depth so that I have a solid understanding of the results you’re looking for. I also provide an idea of the limitations of the treatment to ensure we are on the same page. My most satisfied patients go into their procedures with realistic and reasonable expectations.

So do you think you’re a candidate? If you’re interested in finding out more about Smartlipo, I invite you to contact our office for a consultation. Use our online form, and your consultation is free.

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What the CoolSculpting® Ads Don’t Tell You

Learn the truth about CoolSculpting from Spokane doctor.

With the help of celebrity spokespeople such as Molly Sims, the CoolSculpting® treatment has become increasingly popular and taken the cosmetic surgery industry by storm. As a provider of CoolSculpting at my practices in Spokane and Coeur d’Alene, and one of a handful in the country to offer DualSculpting™, I can attest to the results it can provide.

However, there are a few aspects of CoolSculpting that the ads fail to mention. As a doctor, I feel responsible for educating my patients about the treatments I offer so they know more than just what is advertised. So in this blog post, I’ll share the aspects of CoolSculpting that the ads don’t mention, and discuss why they help to reveal optimal results.

Your skin will look like a “stick of butter,” but we will massage it away.

Immediately after your treatment, the skin where the CoolSculpting applicator was placed will be bright red and look like a rectangular “stick of butter,” as some patients say. That’s because during the treatment, the CoolSculpting device sucks a fatty bulge snugly into the applicator. This ensures the Cryolipolysis® (fat-freezing) treatment is concentrated to that area and evenly distributed among the fat cells. But don’t worry — the shape won’t last. As soon as the applicator is removed, we’ll rub the treated area of your skin, which is highly elastic, and it will return to its original form.

You will have some soreness, but it will go away soon.

A CoolSculpting treatment does cause some soreness and minor cramping in and around the treatment area. This occurs when the treated fat cells begin to die. Once they’re damaged, your body recognizes those cells as waste and removes them through natural processes. This causes inflammation around the treated area, and thus the soreness. This discomfort will last a few days as your body is working extra hard to remove the fat cells, but it should not affect your normal routine.

You won’t see immediate changes, but results will be revealed in time.

The fat cells that have been frozen take time to die and be removed from your body, so you won’t see results overnight. However, you will see improved results in time. Most patients receive at least 2 treatments, spaced a few weeks apart. However, the treatment schedule depends on the area being treated and the results you desire. Results can appear as soon as 1 month after the first treatment, though optimal results are usually revealed about 4 months after the last treatment. Again, this timeline depends on the treated area and the number of treatments, among other factors.

You won’t lose weight, but you will see slimmer, more toned contours.

CoolSculpting is not a weight-loss treatment. It is, however, a great solution for people who have already reached their weight goals and want to tone those stubborn areas where fat just won’t budge. Most patients who visit me for CoolSculpting have already reached their target body weight but still have deposits of fat in their lower abdomen, love handles, thighs, or under their chin. These deposits are often caused by genetic factors and don’t respond well to diet and exercise. These individuals are great candidates for the CoolSculpting treatment, which can be targeted to those specific, tricky areas. Below is a before and after picture from one of my real patients.

To get the best results possible from CoolSculpting, it’s important to receive the treatment under the care or supervision a medical doctor who has been trained by Zeltiq®. Any staff members performing the treatment, such as a physician assistant or nurse, should also be trained. If a staff member is performing the treatment, the supervising doctor should first discuss your candidacy and goals with you and explain the treatment process in depth.

See CoolSculpting before and after images from Spokane.

If you’re interested in CoolSculpting, I invite you to visit our real patient photo gallery to see some of the transformations, like the one above, that our Spokane and Coeur d’Alene patients have seen.

Learn the truth about CoolSculpting from Spokane doctor.

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Top 10 List: Qualities of a Really Good Cosmetic Injectables Practice

Dr. Johnson's top 10 list of what makes a qualified injectorNeuromodulators like BOTOX® Cosmetic and Dysport® and dermal fillers like JUVÉDERM®, Restylane®, Perlane® and now JUVÉDERM VOLUMA® XC are wildly popular worldwide.

According to most research of cosmetic trends worldwide, both of these two entirely different treatments are annually the most commonly performed, everywhere.

In my opinion, the reason people, including my Spokane patients, is the immediate, reliable and reproducible results. This is why we like to use these tools so much in our practice, and our patients love the results.

As a cosmetic surgeon it is most gratifying to be able to perform a liquid facelift procedure in under an hour that reveals immediate, look-in-the-mirror, “holy cow”, “WOW!” results for our patients.

The challenge for patients is to find a safe, reliable, cost effective and ethical place to perform this popular treatment. As with any cosmetic procedure, it is important to feel comfortable with not only the practice and office staff caring for you, but also the person performing your injections.

I am a true believer that cosmetic medicine is a multidisciplinary specialty and all types of backgrounds contribute to the field. But performing cosmetic injections on patients is the practice of medicine. And, these products are only available by prescription.

Here comes the controversial statement –

Although it is legal and ethical for all physicians and nurses to perform cosmetic injections, not all physicians and nurses really perform injectables well.

What are best practices when it comes to cosmetic injectables? A provider can say they are really good at injectables, have been injecting people for a long time, and inject a lot of product, but not be really good at it. I realize the term “good” is partially subjective because the result of this treatment is ultimately what our patients are paying for. But, what makes a cosmetic injectable practice and a provider really good at injectables?

Here is my top 10 list:

  1. A good knowledge of functional facial anatomy including blood supply, muscular and nerve function.
  2. Understand the common (and uncommon) changes associated with facial aging and listen to your patient’s concerns.
  3. Have the ability to diagnose conditions that will benefit from injectables as well as have the ability to recognize when to say “no” if a treatment is not indicated.
  4. Have the ability to inject products that make visible, but subtle, changes in facial appearance that restores a more youthful look….and know when to stop.
  5. Perform the treatment in the most economical way for each patient using the best products possible indicated for that patient.
  6. Have good follow-up evaluation in order to make necessary corrections.
  7. Be able to treat any complication that might occur quickly and correctly.
  8. Have a physician involved in medical evaluation, diagnosis and prescribing treatment and performing follow up for EVERY patient before a needle ever touches a patient.
  9. Have good policies about handling the products in the office with safety.
  10. Have a policy about providers’ “self-injecting”.

Being really good at fillers isn’t about “filling-in” creases and cracks anymore. The understanding of what fillers can do and how they are being used currently in 2014 is really important in getting amazing results with these products. This is reinforced by package insert warnings by Allergan the makers of JUVÉDERM VOLUMA®, one of the newest fillers on the market JUVÉDERM VOLUMA XC® should only be used by physicians who have appropriate experience and who are knowledgeable about facial anatomy and the product for use in deep (subcutaneous and/or supraperiosteal) injection for cheek augmentation.”

Injectable cosmetics is an art form, therefore, personal taste of the injector plays a huge role in the result being sought after in treatment. One last word of warning about choosing a provider is to take a look at your injector’s face. Since many injectors use the products they inject, their face holds some of the artificial enhancements that they consider “pretty”. Do they look overdone, artificial, frozen or too plumped up for your personal taste? If they do, chances are that you will also be encouraged to achieve that look unless you have the sophistication and courage to explain exactly what you’re looking for with your injectable treatment.

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