breast augmentation Chattanooga, Tennessee

Breast augmentation patients  have different motivations for undergoing surgery. Some want to restore volume lost during nursing while others may simply prefer to achieve a more appealing aesthetic. Patients may also seek breast surgery for reasons related to athletic performance. It seems breast implant surgery and breast reduction are two of the most popular cosmetic procedures among female athletes.


Breast Reduction

Breast surgery is not always motivated by sheer aesthetics.  Athletes with large breasts may be at a disadvantage. Not only can oversized breasts be uncomfortable, they can actually interfere with athletic performance. When this is the case, athletes may opt for breast reduction surgery.


A prime example is tennis star Simona Halep.  At the age of 17 the athlete underwent breast reduction. She felt her breasts slowed her reaction speed and caused discomfort. She went from a 34DD to a 34C and seems very pleased with the outcome of her procedure.


While breast reduction can allow for great relief for athletes, the procedure does require some down time. Although most patients are up and walking the day after surgery, strenuous activities (including sports) should be avoided for six weeks.


Breast Augmentation with Implants

Many athletes are characterized by their lean physiques. While such a low degree of body fat beautifully showcases abs and shoulder “caps” , women may also lose most of their breast tissue.  Breast implants are a great way to add a more feminine touch to a lean, athletic frame.


Breast implants can be placed either under the muscle (Subpectoral) or over the muscle (Subglandular). Although under the muscle (Subpectoral) implant placement is typically the most natural and preferred method, over the muscle can be particularly ideal for extremely athletic patients such as bodybuilders who are more susceptible to muscular distortion which sometimes occurs when the implant is placed under the muscle. It is important to note however that subglandular placement does not appear as natural and also carries a higher risk of capsular contraction.  Choosing smaller sized implants can also help with a more natural appearance.


Whether you would like to reduce or enhance your breasts, Board Certified Surgeon, Dr. James E. White,  has several years of experience performing breast reduction, breast lift and breast augmentation surgery. To learn more, call 423-648-4011

photo courtesy of Wikipedia.org

photo courtesy of Wikipedia.org

In recent years, statement jewelry has been quite the rage. In particular, colossal hoop and dangle earrings are a wardrobe staple. While these pieces can certainly add “bling” to your get-up, they can also age and damage your earlobes.

As we age, our skin loses elasticity and volume…becoming thinner and saggier. Earrings bearing significant weight can speed up this process causing the earlobe to droop and the actual piercing to elongate. With time, the piercing becomes more susceptible to tearing.

While simply rejuvenating the ear is a proactive and relatively low-cost procedure, actually repairing a torn earlobe is a bit more involved. Both procedures, however, are relatively straightforward and can be performed in an office setting.

Thin and aged earlobes can greatly benefit from dermal fillers such as Belotero, Perlane or Juvederm. In less than an hour, thin earlobes can be plumped. The additional volume provided by the dermal filler creates the support needed for an earring to remain in its ideal position. The cost of non-surgical earlobe rejuvenation starts around $600. No downtime is required. Keep in mind that fillers are only a temporary fix, lasting up to 2 years depending on the type of filler administered.

For patients concerned more with sagging of the lobes, a “lobe-lift” may be the best solution. With this procedure, excess skin is surgically excised allowing for a lifted effect. The incision is typically placed behind the earlobe and local anesthesia is all that is required.

For patients who have experienced a simple tear of the earlobe, a basic repair surgery is all that is needed. Local anesthesia is applied to the affected area. Then, the two halves are reconnected and approximated with fine sutures which reset the earlobe to a more natural position. Should the patient choose to wear earrings again, they must wait 6 to 12 weeks following the procedure to re-pierce the lobes.

The cost to repair torn earlobes or remove sagging lobe skin varies by surgeon and by region ranging from $350 for simple tears up to $1500 for more complex procedures.

While many options are available for those unsatisfied with the condition of their lobes, the best advice is to avoid heavy earrings altogether. If you cannot avoid oversized hoops altogether, at least wear them sparingly.

Our board certified surgeons offer ear rejuvenation and repair procedures in an accredited office surgery suite using sedation and local anesthesia. Call 423-648-4011 to schedule a complimentary consultation!

lip injectables

Kylie Jenner image courtesy of flickr.com

If you keep up to date with pop culture, you are probably aware of the Kylie Jenner lip challenge and the media’s obsession with her facial metamorphosis. After months of denying plastic surgery rumors, Kylie recently admitted that her sultry and ever so coveted lips were indeed the product of cosmetic lip injections.

Thanks to advancing technology in the field of injectables, “duck lips” are a concern of the past. Recently approved by the FDA, a new line of Hyaluronic Acid (HA)fillers are particularly ideal for temporary lip enhancement. Unlike the original HA fillers such as Restylane and Juvederm which comprised of a larger particle size, the latest variety of injectable fillers have a smaller expanse which allows for more natural results. Unlike Juvederm which tended not to distribute through tissue as easily(resulting in a harder texture), Belotero and Restylane Silk blends much better into the dermis- feeling more natural to the touch. This is not to say that older HA fillers are no longer useful, they simply tend to be more suitable for other areas of the face like the cheeks.

Just like other injectables, Belotero and Restylane Silk can cause bruising and swelling. The best way to minimize the potential for complication is to avoid fish oil, ibuprofen or any other blood thinning agent before and 24 hours following your procedure. While there is virtually no downtime, it is recommended to avoid strenuous activity, extensive sun or heat exposure, alcoholic beverages and other blood thinning agents 24 hours post procedure. It is not ideal to have fillers right before a big event because of the potential for bruising and swelling.

The results of Belotero and Restylane Silk can last at least six months and, for some patients, even longer. Patients typically require only one syringe for lip augmentation. One syringe of Belotero and Restylane Silk costs around $300- $500 depending on where you receive treatment. The session only takes about thirty minutes to perform and results are immediate. To minimize discomfort, we apply a topical numbing agent in addition to an oral nerve block. By the time you receive your dermal injections, most patients will not even feel their lips. Be aware, however, as not all practices offer numbing.

Whether you are wanting to erase the wrinkles around your mouth, restore lost volume of the lips or simply want to enhance your pout, Belotero and Restylane Silk provide wonderful results without an “overdone” effect.

Our Board Certified Surgeons have been performing non-surgical lip augmentations for years. If you are interested lip injections, call 423-648-4011 and schedule your private consultation.

tummy tuck chattanoogaPregnancy is one of the most beautiful miracles of life. Unfortunately, for many mothers, pregnancy imposes some not so beautiful effects on the body including stretch marks, protruding abdominal muscles and sagging skin. Once a new mother has lost all of the “baby weight”, she may be disappointed to see that her stomach no longer looks the way it did before enduring pregnancy.


When diet, cardio and endless abdominal exercises fail to produce the desired results, tummy tuck surgery, also known as abdominoplasty, may be the only solution. During tummy tuck surgery, excess skin is surgically removed and the abdominal muscles may be tightened. Because the loose skin is removed, the appearance of stretch marks can be reduced as well. This is due to the fact that much of the skin exhibiting stretch marks is excised or removed during abdominoplasty surgery.


While this procedure has been proven highly effective for decades, tummy tuck surgery is a relatively invasive procedure. Before undergoing this elective treatment, here are a few things to consider.


    1. Scars

Although easily concealed, scars will be present at the site of incisions. If you undergo a traditional tummy tuck, incisions are made at the lower abdominals (typically from hipbone to hipbone) and around the belly button. If you are only undergoing a mini tummy tuck, scars will only be present at the lower abdominal area. Although the incision required for each individual is different, belly button scarring is typically inconspicuous and the other incision can be concealed in the skimpiest of bikinis. However, it is a good idea to bring your bikini bottoms with you to your consultation. Many times, wider incisions are necessary due to extensive loose skin and fat deposits. You and your surgeon should be on the same page regarding expectations. Are you willing to gain a scar in order to achieve a flatter, and firmer stomach?


  1. Downtime

Because tummy tuck is a relatively invasive procedure, downtime can definitely be an issue. While it varies from patient to patient, everyday activities should be avoided for a minimum of seven to ten days. If you have a more physical job, then 2-6 weeks of downtime maybe recommended.


Because any lifting should be avoided during recovery, caring for young children may also be a factor unless you have access to extensive childcare. No lifting greater than 10 pounds includes lifting and caring for small children. Once the 6 week mark has been reached, you should be considered fully healed and cleared of any restrictions.


     3. Subsequent Pregnancies

Before committing to the cost, recovery and serious nature of surgical intervention, patients should be done with child bearing. While a tummy tuck will not pose a threat to the health of subsequent pregnancies, patients will most likely need another tummy tuck to keep the desired effect. Unfortunately, prior tummy tuck surgery does not leave patients impervious to further stretch marks and stretched skin. Complete your family, and then consider tummy tuck.


These are just a few factors to contemplate before undergoing tummy tuck surgery. Our board certified surgeons have years of experience with this procedure. Call 423-648-4011 to schedule your private consultation!

Beyonce image courtesy of Wikipedia

Beyonce image courtesy of Wikipedia

Throughout history, distinctive body shapes have been regarded as fashionable or desirable. With passing decades, body type trends have evolved. Depending on the era you live in, you may be lucky enough to naturally posses the figure coveted by mainstream society at any give time.

Back in the 1950’s, Jayne Mansfield and Marilyn Monroe made voluptuous, hourglass figures in vogue. Then, supermodel Twiggy hit the fashion scene in the 1960’s and completely altered beauty standards. As a result, it seemed for decades that thinner more waifish figures (in varying degrees) were considered to be the “ideal body type”. Shift to our current day in age and it appears curves have made a comeback with stars like Jennifer Lopez, Kim Kardashian, Beyonce and Kate Upton reminding society of just how beautiful and feminine curves can be.

With curves trending in the main stream, it seems many female patients are seeking ways to attain more voluptuous breasts, plumper backsides and smaller waists (to emphasize an hourglass silhouette). While women with “boyish” physiques may not have been so lucky during the Maryiln Monroe era, aesthetic technology has come a long way. If you were not born with curves, modern-day technology allows patients to purchase them. Here are some of the cosmetic procedures intended to enhance curves.


Breast Augmentation-

Considered the most popular procedure in the field of cosmetic surgery, a breast augmentation can enhance the size and shape of one’s chest/breast. The procedure only takes 1-2 hours to complete and starts around $3800 depending on the type of implant used. Breast enlargement is one of the most common ways to provide a women with instant curves. The procedure is tried and true but breast implant preferences have definitely changed with the times. In the 1990’s, the trend was to go for a larger, more augmented look. Now, there is a movement towards more natural looking implants. Patients tend to go with a smaller sized shaped implant compared to those patients of the Pamela Anderson era.

Butt Enhancement-

Made popular by celebrities like Kim Kardashian, bigger bottoms seem to be all of the rage. While there are non-surgical ways to boost and build the glutes( like lunges and squats) surgical butt enhancement seems to be one of the fastest growing trends in cosmetic surgery. Surgical butt enhancement can be achieved by different approaches. Whether by fat transplants, gluteal implants or a surgical lift , the American Society of Plastic Surgeons projects that 13,373 Americans elected to augment their bottoms in 2013. Unlike breast augmentation which has been around for years, butt enhancement is a relatively new concept. Gluteal enlargement is regarded by many as the new frontier of cosmetic surgery. While exciting, there are still some uncertainties and reservations as they relate to the dependability and functionality of butt implants. Postoperative recovery requires patients to stay off of their glutes for weeks. This is impractical for many with jobs that require seated positions. Moreover, gluteal implants have a reputation for not staying in place. Unlike breast implants which can be placed under the muscle and contained by the overlying muscle, butt implants are sometime placed on top of the gluteal muscles.


Coveting that feminine hourglass silhouette? Abdominal/flank liposuction can help cinch and sculpt a smaller waist line…allowing womanly hips to pop. Liposuction of the abdomen can start around $2500 and recovery time is typically one to two weeks. Liposuction candidates must have a BMI of 31 or less and posses good skin quality. While liposuction is not a weight loss tool, it can be effective for spot reduction of fat deposits when diet and exercise alone fail to produce results.

While big bottoms are trendy now, keep in mind that, unfortunately, most trends go out of style. You should never undergo something as serious as cosmetic surgery to keep up with the trends. Your decision to complete surgery should only come after serious thought and consideration. If you would like to schedule a complimentary consultation with our Board Certified Surgeons, call 423-648-4011. To view our before and after gallery, visit our website advsurgical.com

ABCS-new-beauty-infographic_lgIn an attempt to provide the utmost in patient care and education , we find it necessary to discern the field of cosmetic surgery from that of  plastic surgery.  As a practice that offers cosmetic surgery, on a daily basis,  we encounter patients who are unable to distinguish “cosmetic” from “plastic”. For this reason, we have published numerous articles expressing the differences between the two fields. One of the articles can be found here.

As the field of cosmetic surgery gains mass popularity, an increasing amount of misinformation has surfaced. In particular, New Beauty Magazine recently published an article containing a shocking amount of deception regarding the field of cosmetic and plastic surgery which ultimately depicts Board Certified Cosmetic Surgeons in a negative light. The American Board of Cosmetic Surgery has devised an informative response to address the inaccuracy resulting from the New Beauty magazine article.  Our mission to provide patient education and safety has prompted us to share this information with our readers.  We hope this will eliminate some of the confusion.

Read the American Board of Cosmetic Surgery’ s response at



Ask beauty-conscious women over 40 for one of their favorite anti-aging tools and many will profess their love for Botox or other neuromodulator treatments such as Xeomin and Dysport. It seems health journals are routinely reporting new benefits from Botox use such as migraine relief, depression management and Hyperhidrosis treatment. With all of these new findings, it is easy to begin to categorize Botox as some sort of panacea.

While neuromdulators are long proven to smooth “11” lines, crow’s feet , neck cords and even subtly lift eyebrows, this magnificent emulsion does have its limitations. Here are three conditions Botox cannot effectively correct.

  1. Deep Lines

Yes, neuromodulators are great for preventing and addressing fine lines but only those caused by facial expressions. Botox works by relaxing those muscles responsible for dynamic wrinkles. Dynamic wrinkles are those lines formed as a result of frowning, squinting, laughing, smiling or scowling. With time, the habitual act of these expressions etch deeper lines into the skin. By relaxing such expressions, you prevent deeper etching of the lines and wrinkles. However, if deep lines persist even when muscles are relaxed, Botox alone will not remove the lines. If the wrinkling is still present after the application of a neuromodulator, you most likely will require an injectable filler to plump the skin and provide dermal volume to push the crease out. If you are experiencing wrinkling from sun damage, a dermal filler is better suited for your condition. Botox will not address this type of wrinkling.

  1. Skin Complexion

While neuromodulators can improve the appearance of the skin by smoothing out fine creases and lines, it has no effect on skin complexion. If you are looking to restore radiance to skin, treatments such as microdermabrasion, chemical peels and laser resurfacing will be better suited to your needs. A proper diet, sufficient water consumption, routine exfoliation and daily application of sunscreen are also great ways to ensure a glowing complexion. Keep in mind that exposure to sun and wind or tobacco use can wreak havoc on your skin.

  1. Sagging Skin

Sagging skin results as elasticity of the tissue is lost through aging and skin damage(often inflicted by sun exposure or weight fluctuation). Jowls and heavy eyelids are two popular expressions of this condition. While Botox can subtly lift the eyebrows and provide a slight improvement to eyelids, Botox is not equipped to address these issues. Although dermal fillers like Perlane, Restylane or Juvederm can provide a bit of relief, the most effective and proven way to lift sagging skin is through surgical removal or lifting of excess skin. A facelift is the best way to address jowls while blepharoplasty (eyelid lift) is ideal for correcting drooping eyelids.

While Botox is valuable for a number of conditions, it is definitely not a miraculous cure all. It is important for patients to have reasonable expectations before pursuing this treatment.

Our Board Certified Surgeons have years of experience with injectable neuromodulators. To schedule your complimentary consultation, call 423-648-4011.

Cosmetic Surgery after weight loss

Constantly reminded by health experts and physicians to get our eight hours of beauty rest, sleep is regarded as one of the biggest defenses against aging. However, sleep may be responsible for giving you wrinkles…in an inadvertent way.

While an adequate night’s rest is a legitimate way to ward off premature aging, the position in which you sleep may be responsible for fine lines and wrinkles. In fact, the American Academy of Dermatology explains that sleeping face-down or sideways may cause lines of the face, neck and chest. Crow’s feet and cleavage wrinkles are common results of repeatedly sleeping on one’s side or stomach. In fact, you can distinguish sleep lines from average wrinkles by applying pressure to the area you sleep on. Are the lines magnified? Chances are, these lines are a result of sleep positioning.

Not to worry, there are very simple, natural solutions to this sleep dilemma. The most straightforward way to prevent such wrinkling is to change your sleep position by training yourself to sleep on your back. This is the most cost-effective way to address sleep lines. If sleeping flat on your back is not an option, there are specialty pillows available for purchase.

Worn like a bra, there is a pillow intended to prevent chest wrinkling by acting as a wedge between the cleavage. To prevent lines of the face, there are memory foam type pillows claiming to prevent wrinkling. Keep in mind, not much is known regarding the actual proof of effectiveness. Many cosmetic surgeons and dermatologist believe claims by such pillow manufacturers to be dubious. While specialty pillows may provide a little aid, you should not expect a miracle. If it sounds too good to be true, it probably is.

If crow’s feet are already visible, you may want to consider a solid plan of attack with a neuromodulator like Botox, Dysport or Xeomin as they are long proven to erase these lines. Neuromodulator treatments start around $300, take only 30 minutes to complete and results last up to four months. Chemical peels and microdermabrasion are the most conservative ways to approach “cleavage wrinkles” and are generally suited for patients on the less severe end of the spectrum as they only address the most superficial layers of skin. These mild treatments start around only $100 and do not take long to complete but may cause temporary redness and peeling of the skin. If cleavage wrinkles have become permanent fixtures on your chest, laser treatment, dermabrasion or deep chemical peels are likely a viable solution.

Laser resurfacing is ideal for patients with deeper wrinkling of the chest. A variety of laser technology is available to address these conditions. Erbium, YAG and CO2 (carbon dioxide) lasers are the most common types of lasers used for skin resurfacing. Erbium works at a more superficial, less invasive level while CO2 Laser works at a deeper skin level and is one of the most invasive lasers. Another option is the fractionated YAG laser which is less invasive yet does not penetrate as deep as the CO2 laser. Laser resurfacing costs around $300-$1000 per session.

Undoubtedly, sufficient sleep is important for your health, but make sure your positioning is not wrinkling you. It is best to train yourself to sleep flat on your back, but if it is already too late, you may need cosmetic intervention.

To find out which treatment is best for you, call 423-648-4011 and schedule a complimentary consultation with our Board Certified Surgeons.

photo courtesy of Wikipedia.org

photo courtesy of Wikipedia.org

Like most of the patients we see, you have probably been careful to pamper your hands, face and neck by applying sunscreen daily, being faithful to your regimen of anti-wrinkle creams and perhaps even receiving some aesthetic intervention with laser treatments and injectables. Yet, you may have overlooked a tell-tale sign of aging- the earlobes.

Just like everything else on planet Earth, with age, earlobes fall victim to gravity and collagen loss. This causes the earlobes to appear long, droopy and aged. If you ever went through a fashion phase consisting of large hoop or chandelier earrings, chances are, your piercing holes have also been altered as the weight of the earring pulls and stretches the piercing site.

Depending on the specific problem, a treatment plan does exist. Whether it be earlobe repair by surgical intervention or earlobe rejuvenation by means of injectable, dermal fillers, you are not doomed to droopy, misshaped, thin or torn earlobes.

Earlobe Rejuvenation with Dermal Fillers
Dermal fillers such as Juvederm and Perlane are ideal for earlobes that appear floppy, saggy, thin or stretched. Injected through a syringe, the hyaluronic acid, a substance found naturally in the human body, provides volume to the earlobes-causing them to appear more youthful, plump and smaller. This treatment takes only about 30 minutes to complete and requires no downtime although bruising and swelling may temporarily result. The earlobes do not typically require much product and can generally be treated with 1 syringe which costs about $500. Results can last up to two years.

Earlobe Repair or Reduction Surgery
While many patients respond well to dermal filler therapy, some patients with tears or earlobes stretched to the extreme require surgery for alteration and repair.
When a simple tear occurs, the patient requires only a simple procedure. Using just a local anesthetic , the surgeon can reconnect the split earlobe with small sutures and restore the tissue back to its original shape. For patients needing an earlobe reduction, often common with those who have received ear gauges, the procedure is a bit more complex but still relatively straightforward and can be completed in an office surgical suite. The reduction is performed by surgically removing the excess tissue and augmenting the earlobe to a more visually pleasing shape. All branches of the military require earlobe correction prior to induction. Military uniform code states that ear piercings can not show light when the piercing jewelry is removed.

Upon healing, a thin white scar may be present but should fade over time. At our practice, we include laser scar treatment with the surgical cost for earlobe repair. Depending on the severity and complexity of the case, earlobe surgery ranges from $400 to $1500.

If you are interested in rejuvenating your thinning earlobes, reducing the size of your lobes or repairing a torn lobe, call 423-648-4011 and schedule a complimentary consultation with our Board Certified Surgeons.

Photo courtesy of dreamstime.com

Photo courtesy of dreamstime.com

Most of us know Botox can be useful in treating a variety of conditions such as fine lines, wrinkles, excessive perspiration and migraine headaches, but now recent studies suggest Botox may also be effective in helping to relieve depression. Botulinum toxin as an anti-depressant? According to researchers at the Hannover Medical School in Germany, yes.

A total of 30 patients who possessed chronic depression unresponsive to traditional forms of treatment participated in the study. Essentially, patients randomly received a single injection of either botulinum toxin or a placebo. Injections were placed at the “frown-line” area (between the eyebrows). At a six week post-treatment follow-up, Botox recipients reported a 47.1 percent decrease in depression related symptoms whereas placebo recipients only reported a 9.2 percent reduction in depression related indications.

Study analyst Professor Tillmann Kruger explains, “Our emotions are expressed by facial muscles, which in turn send feedback signals to the brain to reinforce those emotions. Treating facial muscles with botulinum toxin interrupts this cycle.”

Have you ever heard smiling can actually trick your brain into thinking you are happy? This is the essence of Botox therapy.

The study has since been replicated in two similar investigations, giving Botox injection therapy a promising reputation in the field of psychiatry. Where oral anti-depressants present a myriad of possible side-effects, Botox therapy for depression exhibits no evidence of side-effects other than an added bonus-a reduction in wrinkles and fine lines. Moreover, oral depression medications typically require daily use whereas a single injection of botulinum toxin lasts around three months.

Because insurance does not currently cover Botox for depression, this form of treatment can be costly- starting around $500 per treatment. But for many depression patients resistant to traditional therapy, the investment may be worth a try. Worst-case scenario, reduction in depression may not be notable, but frown-lines are erased allowing for a happier, more youthful appearance.

Botox injections only take around 30 minutes to perform and require no downtime. Patients report minimal discomfort.

If you are interested in frown-line treatment, call 423-648-4011 and schedule your complimentary consultation with our Board Certified Surgeons.

Information for this article was referenced from “More Evidence Botox Works for Depression” by Caroline Cassels found on webMD.com