Dreamstime Stock Photo

Dreamstime Stock Photo

Let’s face it: most of us would love to lose some “lbs.”. Yet, unfortunately, many of us are unsuccessful in our attempts to slim down. As a result, we learn to dress in a way which conceals our trouble areas and accentuates our leaner features. What if, however, one of the your trouble areas exists in the facial region (think..double chin, chubby cheeks)? You can’t exactly compress your chipmunk cheeks with a pair of Spanx. Fear not. The field of aesthetics has you covered. Below are three ways to slim and sculpt your face.

1. Buccal Fat Removal
Everyone is born with fatty tissue in the lower facial region known as buccal pads. These buccal pads provide a youthful, “baby face” effect. For some, however, they create a “chipmunk” or “chubby” cheeked appearance. This is adorable on children and many will grow out of this phase . For those who do not, self-esteem issues can develop. As a result, many individuals will feel they look overweight or unattractive. Buccal fat pad removal is a procedure that involves removing the oversized fat pads to achieve a more chiseled look to the cheek, essentially hollowing the area. While this can provide great contouring to qualified candidates, this can also “age” some. This is why it is important to discuss your concerns with an experienced surgeon. Buccal Fat removal is completed with very small incisions inside the mouth with minimal scarring.

2. Facial Liposuction
The double-chin is a common complaint for many. Even those who are physically fit struggle with this stubborn, fat deposit. Unfortunately, you cannot spot reduce the double-chin with exercise or diet. You can , however, with liposuction. Liposuction surgery can be performed to remove fatty deposits under the chin and on the jawline. It is a relatively simple and straightforward procedure that only takes 30 minutes to an hour to perform. Upon recover, which typically lasts a few days, swelling will be present. It is crucial to wear a compression garment until the swelling subsides. Laser addition to standard liposuction can result in skin tightening at the site.

3. Chin Implant
A small, weak chin can often cause one’s face to appear round and undefined. A chin implant can alter facial structure and provide a more aesthetically pleasing shape. As an added bonus, it can reduce the appearance of a double-chin and cause the nose to appear smaller. While very subtle, chin augmentation can provide effective results. The procedure costs around $3000 and takes only an hour to perform. Unlike breast implants, chin implants are approved for lifetime use which means you never have to replace the device. We have had many pleased chin augmentation patients at our practice and the procedure is considered one of the fastest growing cosmetic surgeries to date. Many are deeming it “the new boob-job”. Chin implants are most commonly solid silicone, placed through a very small incision below the chin and can be completely reversed.

If you want to learn more about any of these slimming procedures, call 423-648-4011 and schedule a private consultation with one of our Board Certified Surgeons. Don’t let a case of “chipmunk cheeks” and “double chins” keep you from looking your best.

BrowLift And Blepharoplasty Before After Chattanooga

It seems more men are seeking cosmetic surgery as a means to regain their confidence and maintain a competitive edge over their younger colleagues in the cut-throat workforce. From Botox and liposuction to hair restoration and face lifts, men are feeling an increasing amount of pressure to look youthful and fit.

Typically, one of the first places we show signs of aging is our eyes…the first feature many will notice. As many men approach their fifties, they begin to exhibit hooded upper eyelids or sagging brows. This tends to result in an angry, sad or sleepy appearance. While a brow lift can correct these conditions, eye rejuvenation needs to be tailored specifically to accommodate each sex as fundamental differences exist between the structure of a female’s eyebrow versus a male’s. Males seeking this surgery run this risk of looking feminine if they do not select their surgeon carefully. Just because a surgeon has proven himself competent at female brow lifts does not mean he is also proficient at male eye rejuvenation.

If you compare the facial features of a man against those of a woman, you will notice many subtle differences. Observing the eyebrows, there is not only a difference in shape but in positioning as well. Females have a higher brow arch while men have little to no arch. As both sexes age, their brows begin to gradually droop. For men, eyebrows that once sat directly on the brow bone descend below the brow bone. As a women ages, her brows will descend from above the brow bone down to the brow bone. This position change may only be millimeters; but what a difference in facial aesthetics.

As far as eyelids are concerned, males naturally posses heavier upper eyelids than females. This makes men more susceptible to early vision interference due to “hooded lids”. When performing eye rejuvenation on males, it is critical that the selected surgeon has the ability and attention to detail to distinguish the traits which make a brow or eyelid either masculine or feminine.

With such considerations in mind, we approach male eye rejuvenation differently from female eye rejuvenation. With male patients, we are careful to excise less skin, aiming to reposition the brow only to the brow bone, while also maintaining a masculine shape. If you have ever witnessed a bad example of a forehead lift on a man, his brows were most likely re-positioned too high. Also, the surgeon may have imposed a feminine effect on him by arching his eyebrows. This is why it is critical to review before and after photographs of work that has been completed by the surgeon you are considering. Does he/she have examples of male eye rejuvenation in his portfolio? Do you like what you see? Choose your surgical artist well. Chesk out our before and after gallery at ADVSurgical.com.

Eye rejuvenation surgery can be a very powerful tool to turn back the hands of time. If you are interested in exploring brow or eyelid lift treatment, call 423-648-4011 and schedule your complimentary consultation with our Board Certified Surgeons.

© Phil Date | Dreamstime Stock Photos

© Phil Date | Dreamstime Stock Photos

Ready or not, wedding season has commenced. Whether you are the bride, mother of the bride , bridesmaid or simply acquaintance of a bride or groom to be, chances are high that you will be attending a wedding within the next few months.

While the wedding is typically all about the bride, cosmetic wedding preparations are a great idea for anyone wanting to put their best foot forward. After all, weddings are often a time to reunite with friends and family you may not have seen in ages. Who wouldn’t want to look their best? Here are a few procedures to consider before that big day.

1. Neuromodulators-
Neuromodulators like Botox, Xeomin or Dysport are one of the most common and basic cosmetic procedures performed in the United States. Often costing anywhere from $250 to $700 per treatment, neuromodulators are injected to relax the muscles responsible for creating crow’s feet and frown lines. These injectables can also be used to provide a natural lift to the eyelids and brows. While there is essentially no downtime required for this treatment, don’t wait the day before your wedding to have the injections completed as results typically take 1 to 3 days to surface. We recommend patients schedule this treatment 6 weeks in advance of their big day. Botox injections only take about 30 minutes to complete and results last 3-4 months.

2. Fillers-
Often performed in conjunction with neuromodulators, fillers are an injectable solution to fine lines, wrinkles and volume loss caused by aging and skin damage. Fillers can be used to plump lips and sunken cheeks, rejuvenate hands and undereyes or fill in those unsightly crevices around the mouth. Ranging from $400 to $600 a syringe, patients may need anywhere from 1 to 3 syringes depending on how many areas need treatment and the severity of the problem area being treated. Although fillers do not necessarily result in downtime, swelling and bruising at the site of injection are common. This is why we recommend patients book this procedure at least 4 weeks ahead of their event. Fillers take around 30 minutes to an hour to complete and, depending on the type of filler, can last as little as 6 months or as long as 2 years depending on the filler and technique.

3. Chemical Peel or Laser Resurfacing-
Looking to erase dull, sun-damaged skin? Varying in degrees of intensity, from light to deep, chemical peel or laser resurfacing are a cost effective and non-surgical solutions for sun damaged skin. Applied as a topical gel, chemical peels are used to remove the dull, damaged surface layers of the skin to reveal the more radiant, youthful layers of the dermis. The more intense the chemical peel, the deeper the peel penetrates. According to the depth and the potency of the peel, pain is typically minimal if not non-existent all the way to intensive requiring IV sedation. Lasers can take the resurfacing to a whole new level. While chemical peels and laser resurfacing are considered non-invasive, redness and flaking often results after treatment, so we recommend booking this procedure a few weeks to months ahead of your event depending on the level of resurfacing and expected changes.

Just like high school reunions or holiday gatherings, weddings are major life events that motivate many to diet, exercise and even make a visit to their cosmetic surgeon to dress up and be the best that you can be. Even if you aren’t the bride, it is perfectly normal to want to look your best…think of all the photos that may be taken…..show your best side.

While these pre-wedding “touch ups” aren’t as dramatic as undergoing a surgical procedure such as a facelift or brow lift, they can certainly take years off of your appearance to gain the glow. If you are considering a pre-wedding touch up, call 423-648-4011 and book your private complimentary cosmetic consultation.



Thunder thighs, bat-wing arms and muffin-top plague many women in their quest to attain a sleek silhouette. As if a girl has enough to worry about, wearing a supportive bra often results in another undesirable effective….bra rolls.


Also known as “back fat”, bra rolls often appear in the upper back at the bra line and are a result of excess fatty tissue or lax skin which is often “magnified” when the pressure of a brassiere is applied. For many, this condition gets worse with age. Because of the location of the tissue, it is often a trouble area tricky to address with exercise alone. So, what is a girl to do? It definitely limits ones wardrobe.


Sure, you could wear looser, less supportive brassieres or ditch them altogether, but then you set yourself up for sagging breasts and poor posture. You could also amp up your fat burning efforts with stricter devotion to proper nutrition and fitness. The problem many women are finding, however, is that no matter how much weight they may shed, their body refuses to rid itself of fat in this area.


While many companies have recently developed compression garments specifically designed to eliminate “back fat” or “bra rolls” , such products have their limits. Some garments are simply ineffective while others are hard to conceal, especially in more revealing clothing.


Unfortunately, the only way to isolate or target specific trouble areas is through surgical intervention. The two main methods of bra-roll attack are liposuction or skin tightening and excision with an upper back lift. So, which procedure are you best suited for?



Bra Fat Liposuction

For younger patients with robust skin quality who simply wish to reduce the amount of fatty tissue at the bra line, liposuction is a less invasive option. Liposuction of bra fat rolls is very effective in reducing the appearance of bulging fatty tissue at the upper back. Even better, liposuction requires less recovery and surgical time and is more affordable than a bra-line backlift. It is important to note however, due to the fibrous characteristics of the upper back, this area can be more challenging to treat. This is why it is important to do your research before selecting a surgeon to complete this procedure. While liposuction is effective in removing fat volume, liposuction will not address lax, sagging skin. Some patients are surprised to learn that what they may really need is a back lift, not liposuction.



Bra- Line Back Lift

When a patient displays poor skin elasticity and significant skin laxity, liposuction is ineffective.  In fact, liposuction alone can make the area worse. For this type of patient, a bra-line back lift is best. In fact, many post-bariatric surgery patients are great candidates for this procedure as they have lost a significant amount of body fat yet struggle with loose skin where fat cells once resided.


During a bra-line back lift, an incision is made at the bra line on the back. Excess tissue is then removed and/or tightened into a lifted position. Upon healing, patients will most likely still display scarring at the incision site. Luckily, many patients are able to conceal their scar with their bra. This procedure typically takes 60 to 90 minutes to complete and starts around $6,000. Recovery typically takes one to three weeks.


During your consultation with our board certified surgeons, your treatment plan will be established whether it be simple back liposuction or a bra-line back lift. If you would like to banish the bra-roll, call 423-648-4011 and schedule your complimentary consultation!

Plastic Surgeon Chattanooga, Tennessee

While many prospective breast augmentation patients may have visions of sexier, skimpier brassieres on their mind and a trip to Victoria’s Secret on their post-op to-do list, breast implants actually require sufficient care and attention. Many of the breast patients we initially consult with in our practice have been misled to believe that “fake” breasts cannot sag like natural breasts and therefore , do not need complete support…….hence the new wardrobe of lacy bras that serve no function and provide no support are far from truth.

Although rare, breast implants can displace and descend below the original pocket. Also known as “bottoming out” , this complication occurs when there is not enough support to keep the implant in place. As a result, the implant drops low on the chest and causes the nipple to appear abnormally high on the breast mound. Not a natural or optimal look.

While any size or type of breast implant is susceptible to “bottoming out”, larger implants are more likely to pose this risk from shear weight. Implant placement also plays a factor in the likelihood of implant displacement. Implants placed above the muscle are more likely to descend than those placed completely under the muscle. Under the muscle provides more support with dense tissues. Also a factor is skin type as women with thin breast tissue are particularly at risk.

Bottoming Out: Prevention

The best way to prevent implant displacement is to follow your surgeon’s post-operative instructions. Support, support, support. Because smoking can damage  skin elasticity, it is also advisable to refrain from nicotine and tobacco use. While it may be tempting to go bra-less, or only wear those cute lacy yet functionless bras, implants need proper support just as natural breast tissue. Cute and lacy may be used for limited amounts of time; but support bras should be a daily routine.


When performing high risk activities, breast augmentation patients should use common sense. Activities that involve excessive bouncing like running and horse-back riding will put extra pressure on breast tissue. Therefore, it is wise for patients to invest in highly supportive sports bras.

While breast implants are great for restoring youth, volume and perkiness of the breast, patients must take care of their investment so that their results remain aesthetically appealing. If you are interested in breast augmentation surgery, call 423-648-4011 and schedule your private, complimentary consultation with our Board Certified Surgeons.

breast reduction

Image Courtesy of Dreamstime

Looking to go down a cup size? You may not need as invasive of an approach as breast reduction surgery to accomplish your goals. For patients who desire only a small decrease in breast volume, no lift…no drastic alteration in size.., liposuction can be a viable option.

Breast Reduction Surgery

While formal breast reduction surgery is a well-established procedure with a successful track record, it comes with a price: visible scarring, post-operative discomfort and increased surgical costs.

During a formal breast reduction surgery, multiple incisions must be made including one around the nipple, another vertically under the nipple plus or minus additional incisions.  If a large nipple lift is needed it may be necessary to complete a long anchor incision at the horizontal crease under the breast. Excess skin and breast tissue are then removed and re-contoured using a combination of liposuction and sharp dissection to lift the nipple and shape the breast.  Eventually, these incisions result in visible scarring.  While, in less severe cases, we can use a less invasive incision technique to reduce the appearance of scarring, breast reduction surgery is ultimately more intensive than a simple reduction by means of  liposuction.

Following breast reduction surgery, patients typically require 5 to 8 days of recovery. Although most patients are up and walking the day after surgery, strenuous activities should be avoided for six weeks.

For patients seeking a significant change in size and a re-contouring effect, breast reduction/lift surgery remains the best course of action.  Not only can it reduce breast size, it can also lift, firm and provide a more “perky” appearance to sagging breast. The cost of breast reduction surgery can range anywhere from $5,000 to $8,000.

Reduction with Liposuction

Another breast reducing option is breast reduction liposuction.  Although still a surgical procedure, is considered less invasive, less costly and results in minimal to no visible scarring.  While liposuction cannot drastically alter size, provide lift or a more pleasing contour, it can decrease breast volume by one cup size.   Skin reduced in size will often respond with some skin tightening.  For patients only wanting a small reduction, liposuction may be the more sensible option.

During liposuction, the breasts are treated with a tumescent solution intended to numb the area and control bleeding. The cannula, less than 3mm in size, is inserted through small 3mm incisions. VASER ultrasound can be used to dislodge fat from the surrounding breast gland tissues using sound waves.  The liposuction cannula then suctions the desired amount of fat tissue from the treated areas.

Following breast reduction with liposuction, patients will be required to wear a compression garment for 1 to 3 weeks. Depending on the patient’s occupation, many can return to work only a few days after surgery.  The cost of liposuction starts around $3000.

While patients desiring more extensive changes in breast size and contour may be better off with formal breast reduction surgery, patients only hoping to achieve slight alteration in size can bypass increased costs, scarring and recovery time by opting for reduction by liposuction.

If you are interested in exploring your options, call 423-648-4011 to schedule you complimentary consultation with our Board Certified Surgeons.

mommy makeover
A few weeks ago, many of us took the time to thank our mothers for all of the contributions made  throughout the years- the sleepless nights, the comforting words and, for many, the domestic drudgery .  Yet a commonly overlooked aspect of motherhood is the havoc pregnancy can wreak on one’s body. We don’t often acknowledge our mothers for the stretch marks, varicose veins, deflated breasts and loose tummies which we inflicted on them while they carried us for nine months during pregnancy.


Truth be told, pregnancy is not kind to the feminine form. Yet, is seems the media camouflages this unfortunate truth by saturating viewers with unrealistic, celebrity stories- perpetuating outrageous accounts of “how (insert celerity name here) returned to her pre-pregnancy figure within 6 weeks of giving birth”. All the more enraging, thanks to photo airbrushing, I have yet to see one of these celebs exhibiting stretch marks or unsightly veins. So, what are “real” mothers to do?


While society can be quite cruel to the average mother, there is a line of defense.  With the exception of stretch marks, advancing technology has provided effective solutions to the many battle scars of pregnancy through the form of breast augmentation, tummy tuck, laser vein therapy and vaginal rejuvenation surgery. Combine more than one of these procedures in a single surgical session and you have what is called a “mommy makeover”.


Mommy makeovers are ideal for busy moms that do not have time to endure multiple surgical sessions and the accompanying recovery time required. Moreover, many cosmetic surgeons offer discounted fees when the patient opts to combine multiple procedures.


Our mothers  may not have been as fortunate as we modern-day mommies as cosmetic surgery has become much more accessible to the general public. Not only is it now more financially feasible, the field of cosmetic surgery itself has continued to grow allowing for more options, greater patient satisfaction, increased safety and improved outcomes.


This is not to say that all mothers should regard their “battle scars” as something shameful- seeking surgical intervention to correct these imperfections. However,  mothers plagued by diminishing self-esteem due to adverse body changes should know that there are solutions…no one should have to wallow in body image depression.


If you are interested in a mommy makeover, call 423-648-4011 and book your complimentary consultation with our Board Certified Surgeons or visit www.advsurgical.com.

Plastic Surgeon Chattanooga, TennesseeIn 1992, a sense of panic overshadowed the credibility of breast augmentation surgery after the FDA removed silicone breast implants  from the market. The ban was enforced out of suspicion that the devices were responsible for connective tissue disorders, autoimmune diseases and cancer. As a result, saline became the go to material for breast implantation.   Fast forward more than twenty years, and you will notice a stark contrast in breast implant preference among women.

According to the American Society of Aesthetic Plastic Surgery (ASAPS) , 72 percent of the implants used in breast augmentation surgery today are silicone. Based on such data, it is fair to say that silicone breast implants have become the more popular choice since their reintroduction to the market in 2006. But what distinguishes new silicone implants from the older form of silicone?

New Silicone Implants versus Old Silicone Implants


Differing from the implants used in the 1960’s thru 1990’s, the shell of  modernized silicone implants are more durable. They are so durable that their  rupture rates are practically negligible. In addition to an  improved implant shell or covering,  the actual silicone filling has transformed from a once oil-like substance to a  more cohesive,“gummy bear-like” silicone gel. As a result, free silicone implant leakage is nearly impossible.

While leakage or silicone migration instances are extremely rare, it is critical to note that  the inability of silicone implant deflation makes rupture detection difficult.  Unlike saline implant deflation where the water filling actually leaks and deflates, the only way to detect silicone implant breakage is by breast MRI.

After fourteen years of silicone implant research and an additional seven years of market use,   silicone breast implants have proven to be safe when used properly. However, whether you choose saline implants or silicone implants,  the devices are not constructed for lifetime use. It is recommended patients exchange their breast implants every ten years. To screen for possible silicone implant breakage, patients are  also advised to receive a breast MRI every three years.

Why is silicone more popular than saline?

So, why do the majority of patients and surgeons prefer silicone? Implant preference is often based on cosmetic reasons.  Silicone implants tend to look and feel more natural than saline implants. They also present less of a risk for visual rippling and capsular contracture.  Please note,  the FDA has not approved silicone implants for use in patients under 22 years of age.

If you would like to learn more about breast implant options, call 423-648-4011 and schedule a complimentary consultation with our Board Certified Surgeons or visit www.advsurgical.com

male breast reduction chattanooga
Often considered only a feminine concern, breast reduction surgery is becoming increasingly popular among males. It seems an amplification of body image pressures are taking a toll on the male population. In fact, in 2012, the popularity of male breast reduction surgery increased by 5 percent from the previous year . Like male pattern baldness or “beer belly”, gynecomastia is yet another potential threat to masculine allure.


Gynecomastia (“man breasts” or “man boobs”) is a condition which creates enlarged, benign breast tissue in men. Up to a whopping 69 percent of males will experience this condition at some point in their adolescence during hormone surge. While gynecomastia most commonly occurs within the confines of male puberty, it can persist into adulthood. For those patients who experience enlarged breast tissue into adulthood, surgical intervention is often the only solution as true gynecomastia is unrelenting to weight loss programs.

Psychological Impact of Gynecomastia

Until recently, gynecomastia was considered only a cosmetic concern. However, a study published in the April issue of Plastic and Reconstructive Surgery reveals the psychological impact that the condition may pose to men who suffer with gynecomastia. According to the study, it was inferred that gynecomastia adversely affects self esteem and overall quality of life in those participants diagnosed with the condition.

The study assessed a group of 47 boys being evaluated for gynecomastia. Participants were given a series of psychological tests. The results were then compared to a control group of participants without gynecomastia. Compared to the control group, patients with gynecomastia generated lower scores on tests which were constructed to evaluate general health, mental health, social function and self esteem.

Dr. Brian Labow who conducted the study explains, “Merely having gynecomastia was sufficient to cause significant deficits in general health, social functioning, mental health, self-esteem, and eating behaviors and attitudes compared with controls.”

Given the findings of this study, it is natural to assume that the treatment of gynecomastia may not only result in cosmetic improvement, but a potential psychological improvement as well.

Gynecomastia Treatment

In mild cases, liposuction alone can correct Gynecomastia. However, patients with a considerable amount of tissue or poor skin quality will need to undergo a formal breast reduction involving the surgical excision of excess breast tissue along with liposuction. For three to six weeks following the surgery, patients are advised to refrain from strenuous activities . It is also important to note that scars will be present at the incision sites. Typically, cost for breast reduction starts at around $4,000.

We offer male breast reduction at our surgery practice in Chattanooga, Tennessee. If you are interested in scheduling a private, complimentary consultation with our Board Certified Surgeons, call 423-648-4011.

By Dr. James White


While many cosmetic surgery candidates assume breast implant size is the only variable in breast augmentation outcome, they are misinformed. Breast implant type, shape and positioning also play an important role in breast enhancement cosmetic results.

Although a fair amount of patients are aware of the pros and cons of implant type (saline or silicone?) and size (small “C” cup or DD?), a vast majority of patients do not realize the role implant placement plays in the overall aesthetics of breast enhancement. In fact, breast implant placement can be executed through several different approaches. Primarily, they can be placed completely under the muscle (subpectoral), over the muscle subglandular or partial sub muscular (dual-plane).

Under the Muscle/Subpectoral

When a surgeon refers to “subpectoral” or “under the muscle” placement, this typically implies that the implant will be placed completely beneath the pectoralis muscle. This technique can be advantageous particularly for women with extremely thin tissue as this type of placement allows the entire implant to be camouflaged and padded by overlying muscle and existing breast tissue. As a result, wrinkling and rippling of the implants less likely. In addition, this technique greatly reduces the likelihood for capsular contracture (hardening of the breast due to the abnormal development of scar tissue of the capsule around the implant). Although this techniques has many advantages, it can cause more immediate postoperative discomfort and require longer recovery time than subglandular placement. Flex of the pectoralis muscle with submuscular implants can cause implant distortion.

Over the Muscle/Subglandular

Subglandular placement is executed by placing the implant over the pectoralis muscle directly under the breast tissue . While this technique may not require as long of a recovery and less postoperative discomfort as subpectoral placement, the chances for capsular contracture are greatest with this approach. At our practice, subglandular placement is not the preferred method not only due to potential for capsular contracture but also because of the potential for visible implant rippling and a less natural feel of the breast implant. However, it can prove beneficial for extremely athletic patients such as bodybuilders who are more susceptible to muscular distortion which can occur when the implant is placed under the muscle.

Dual-plane/Partially under the muscle

When a patient exhibits a slight droop of the breast, often due to deflation of the breasts after a pregnancy or weight loss, yet still possesses good skin quality, we often prefer to perform a dual-plane breast augmentation. A dual-plane placement allows for the upper portion of the implant to be covered by the pectoralis muscle while the lower portion of the implant is only subglandular. This technique provides a gentle lift, without the need for a more invasive breast lift and the scarring and discomfort that a formal breast lift entails. Even better, this technique still has a low likelihood of capsular contracture formation, the best of both worlds.

In order to accurately determine the most beneficial placement for your unique body, it is necessary to consult with a Board Certified Surgeon experienced in breast augmentation surgery. To book a private complimentary consult with our Board Certified Surgeons, call 423-648-4011.