For many medical procedures, local, regional, or general anesthesia is usually involved. Cosmetic procedures are no different. From the use of local anesthesia for minor facial procedures to general anesthesia for more aggressive surgeries, this powerful drug is utilized by every plastic surgeon.
Anesthesia is safer and more effective than ever before. Advancements in monitoring technology and anesthetic drugs, more continuing education and training, and high professional standards have made the use of anesthesia one of the safest aspects of a surgical procedure.
Local anesthesia inhibits pain in specific areas of the body. Regional anesthesia is used for larger areas of the body. It blocks transmission of pain between the procedure area to the spinal cord. Lastly, general anesthesia works in the brain to relieve the patient of pain. This results in unconsciousness and lack of sensation. There are several kinds of anesthesia. Choosing the right one is based on the patient’s physical condition, the type of cosmetic surgery, and the patient’s reactions to medications.
When anesthesia is administered, the medical professional monitors every important body function constantly. Preparations are also made before surgery. Patients must be open and honest with any food, beverage, or drug that they have taken in the hours prior to surgery. This is because some foods and substances may interfere with the effectiveness of the anesthesia.
Certified Registered Nurse anesthetists (CRNAs) or anesthesiologists are two of the medical professionals who administer anesthesia.  Both of these professionals receive similar educations. Anesthesiologists receive a medical education, whereas CRNAs receive a nursing education. They are both educated on the same anesthesia processes.
You can rest assure that Dr. Carp and his staff are knowledgeable and experienced professionals no matter what cosmetic procedure you decide to undergo. Below is a list of do’s and don’ts as the anesthesia wears off, compiled by the American Association of Nurse Anesthetists:
•    Don’t drive a car for at least 24 hours.
•    Don’t operate complex equipment for at least 24 hours.
•    Don’t make any important decisions or sign any legal documents for the day.
•    Don’t take any medications unless prescribed by or discussed with your physician.
•    Don’t drink alcohol for at least 24 hours.
•    Do leave the healthcare facility accompanied by a responsible adult.
•    Do remain quietly at home for the day and rest.
•    Do arrange for someone to care for your small children or pets for the day.
•    Do take liquids first and slowly progress to a light meal.
•    Do call your nurse anesthetist, your physician, or the facility where you were treated if you have any questions.
Further information regarding your options with anesthesia and plastic surgery procedure of choice can be attained during an initial consultation.

A recent survey by the American Society for Aesthetic Plastic Surgery (ASAPS) revealed that people over the age of 50 ranked youthful-looking skin as the number-one feature they find attractive in others. In a world where so much emphasis is put on facial beauty, treatment for wrinkles is in demand now more than ever.
At Carp Cosmetic Surgery Center, Dr. Steven S. Carp has successfully treated patients for wrinkles using Fractional CO² laser resurfacing. Wrinkles form because of decreased collagen production due to aging, which causes the skin’s support structure to breakdown. This process can be accelerated because of UV exposure and other environmental factors.
Using the Matrix Fractional CO² laser, Dr. Carp can reverse the signs of aging by enhancing the skin’s strength and elasticity. Dr. Carp’s Fractional laser treatment offers patients a cost-effective solution to reduce wrinkles, tighten tissue, and improve texture – all with minimal recovery time.
Fractional CO² laser resurfacing, commonly referred to as a “laser peel,” works by removing damaged or wrinkled skin, layer by layer, through the use of a carbon dioxide (CO²) laser. Dr. Carp moves the laser back and forth over the skin until the wrinkles are less visible. This procedure is primarily used to minimize the appearance of fine lines, but it can also be applied to treat facial scars or areas of uneven pigmentation. Laser resurfacing may be performed on the whole face or in specific regions.
Although this treatment will not remove all wrinkles, it definitely gives individuals a younger-looking skin surface, which is smoother and tighter. Patients with darker skin may be at greater risk for changes in pigmentation, but Dr. Carp evaluates patient’s particular skin characteristics and makes recommendations during the consultation.
Depending on the amount of laser resurfacing needed, local or general anesthesia with sedation, will be used. Most patients are given local anesthesia, which means that they are awake but relaxed, and feel minimal discomfort. Luckily, the procedure is usually quick and can take anywhere from a few minutes to an hour. If the wrinkles are especially deep, two or three sessions may be needed.
After the treatment is complete, protective creams can be used for the first few days. Mild swelling and discomfort will occur, but ice packs and/or prescribed pain relievers can be taken to curb the after effects of the procedure. As the treated area heals, it is vital that patients do not pick the crust that is formed or they may risk scarring. The crust will go away after 10 days, but redness may be visible for several weeks.  Make-up can be applied to the treated area after two weeks.
Dr. Carp recommends that patients use strong sun block to maintain the results and reduce the chance of any new sun damage to the skin. In addition, sunglasses with UVA and UVB filters should be worn if the Fractional CO² laser resurfacing was performed around the eyes.

There are many cosmetic options available to turn back the clocks and achieve a more youthful and rejuvenation appearance. Non-surgical injections are ideal for those who do not wish to face the risk of surgery or have the time to undergo invasive procedures. There are many facial injectables available on the market, each with their own risks and rewards.
Since 1987, Botulinum Toxin Type A, better known as BOTOX®, has been used to treat frown lines, crow’s feet, turkey neck, and other wrinkles in millions of people. At the Carp Cosmetic Surgery Center in Green, Ohio, Dr. Steven S. Carp has been using BOTOX injections on patients who a desire a younger-looking face. In fact, many cosmetic surgeons refer to BOTOX as the new “fountain of youth.”
BOTOX is a safe and effective alternative to surgical procedures, which is why it is one of the most popular facial rejuvenating treatments available today. It works by blocking the release of a chemical known as acetylcholine, which lets muscles know when to contract. Once acetylcholine is blocked, the muscle is relaxed. So when BOTOX is injected into the facial muscle, the skin above it also remains relaxed, flat, and smooth. Patients see noticeable results in a week and the treatment lasts approximately three to four months. Another great benefit is that the lines that return are not as apparent as before.
Even as popular as BOTOX may be, there’s a new kid on the plastic surgery block that’s taking non-surgical injections to the next level. Dysport® is a botulinum toxin similar to BOTOX, but unlike the latter, the effects of Dysport last six months to one year. That’s up to eight months longer than BOTOX. Dysport has been used outside the United States for 15 years, but it is now an FDA-approved non-surgical treatment to treat frown lines between the eyebrows.
For both of these injectables, there are some risks involved. Although complications are extremely rare, Dr. Carp goes over all of the precautions with every patient during the consultation and helps ensure that they have all the information necessary to make an educated decision. If this interests you, please contact our office today to schedule an appointment.

 If you are a male affected by gynecomastia, an enlarged male breast condition, there is a surgical solution that may be appropriate for you. Gynecomastia surgery (sometimes called “male breast reduction”) is a procedure designed to correct this condition and create a smoother, more masculine chest contour. We offer this procedure at Carp Cosmetic Surgery Center. .

Although gynecomastia is not often discussed, it is actually a common condition that affects an estimated 40 to 60 percent of men. Many times, teenage boys are diagnosed with gynecomastia as well. The condition may exist in both breasts, or only one. There are several potential sources of gynecomastia, including obesity, prescription or illicit drug use, impaired liver function, and hormonal imbalance. Other times, there is no known cause.

Male breast reduction can reverse the appearance of gynecomastia by removing fat and/or excess glandular tissue from the chest area. In extreme cases where the condition has led to stretched-out skin, the surgery may also involve removing a surplus of skin. With either method, the result of gynecomastia surgery is a male chest that is flatter, firmer, and better contoured.

The techniques used to remove the offending tissue include excision (cutting out) with a scalpel, liposuction, or a combination thereof. Typically, the incision is made in an  inconspicuous location, such as on the dark skin of the areola or in the underarm area. The exception to this would be a major reduction, one in which the removal of a significant amount of tissue and skin may require larger, more noticeable incisions. If liposuction is used to remove excess fat, the cannula is usually inserted through the existing incisions to minimize overall scarring. Normally, general anesthesia is used for optimal patient comfort.

In the vast majority of cases, male breast reduction surgery complications are rare and minor. However, all surgery carries some degree of risk, including infection, skin injury, excessive bleeding, adverse reaction to anesthesia, and excessive fluid loss or accumulation. With gynecomastia surgery, other risks include permanent pigment changes in the chest area, slightly mismatched breasts or nipples, and slight asymmetry (asymmetry may require a second procedure). Side effects are minor as well, but they include temporary loss of nipple sensation or breast numbness.

During an initial consultation at Carp Cosmetic Surgery Center, you can discuss your options for gynecomastia surgery, and ask questions regarding the procedure. If this interests you, please contact our office for details. We look forward to answering your male breast reduction questions.

For many people who are dissatisfied with the size and/or shape of their nose, rhinoplasty (“nose surgery,” “nasal reshaping,” “nose job”) may be the best solution. At Carp Cosmetic Surgery Center, we offer rhinoplasty to patients who would like to have their nose cosmetically enhanced or to have a functional problem corrected.

Rhinoplasty can effectively:

• Increase or decrease the size of the nose
• Remove a nasal “bump” or dorsal hump
• Narrow the span of flared nostrils
• Change the angle between the nose and the upper lip
• Correct a bulbous tip
• Narrow the bridge 

Some functional purposes for undergoing rhinoplasty may be:

• Correction of a deviated septum
• Nostril repair following drug abuse
• Reconstruction following injury
• Correction of birth defect problems

During an initial consultation at Carp Cosmetic Surgery Center, rhinoplasty candidates can discuss their specific reasons for seeking the procedure and ask any questions they may have.

A word to rhinoplasty candidates: Do not expect rhinoplasty to completely transform your life. Practical, realistic expectations are important for your satisfaction as a patient and your emotional well-being in the future.

Healthy, emotionally stable adults and teenagers who aim to change the appearance of the nose or want to improve its function typically make good candidates for rhinoplasty. Many surgeons prefer not to operate on teens until after they are done growing, which is approximately 14 to 15 years old for girls and even older for boys. Parents: A teen’s social and emotional capacities are also important, so consider your child’s candidacy carefully. 

Rhinoplasty complications are rare, and usually minor. However, the possibility of complications, including infection, nosebleed, or a reaction to the anesthesia is something every patient should be aware of. Patients can reduce their risks by closely following the surgeon’s instructions before and after surgery.

To discuss your rhinoplasty options with Dr. Carp, please contact our office today to schedule an initial consultation.

If women and men are unhappy with having a sagging, puffy, or aged eyelid appearance, they may choose to undergo eyelid lift surgery (“blepharoplasty”). This procedure is designed to correct an unwanted aged look in the eyelids and rejuvenate the area, which can lead to an overall younger appearance of the entire face.

How is eyelid surgery performed? By removing fat, along with sagging, excess skin around the eyes and tightening the muscles of the upper and/or lower eyelids. Eyelid surgery can improve the features that make people look older than they feel, such as drooping upper lids and puffy bags below the eyes. In some cases, these features may even interfere with a person’s vision; in these circumstances, eyelid surgery can also provide some functional correction.

For many Asian patients, the absence of an upper eyelid crease is their reason for seeking out eyelid surgery. The procedure designed to correct this, sometimes called “Asian eyelid surgery” or “Asian blepharoplasty,” involves reshaping the upper eyelids to achieve the desired “Western” look while still retaining the appearance of Asian heritage.

For some patients, eyelid surgery may only be one part of the solution. For instance, those who are unhappy with a sagging brow or overall facial sagging may be best suited for a brow lift, facelift, or some combination of these procedures. On the other hand, those who wish to correct wrinkles or crow’s feet may also choose to receive Botox® injections or another facial injectable; eyelid surgery does not remove wrinkles. In addition, blepharoplasty is not a treatment for dark circles under the eyes.

Individuals who qualify for eyelid surgery are normally at least 35 years of age with sagging eyelids and an aged eye appearance. Depending on their cosmetic goals, Asian eyelid surgery candidates may be younger.

If you have thyroid problems, hypothyroidism, Graves’ disease, dry eyes, a detached retina, glaucoma, high blood pressure, cardiovascular disease, or diabetes, your candidacy for eyelid surgery may be affected. During an initial consultation at Carp Cosmetic Surgery Center, please disclose all medical conditions so that Dr. Carp may thoroughly and accurately advise you.

If eyelid lift surgery is of interest to you, please take a moment to contact our office today. We look forward to answering your questions during your consultation.

These are some of the most common plastic surgery fears:

Fear of anesthesia: Concerns about “going under” with anesthesia are common, and are especially widespread among surgery novices. The knowledge that all board certified plastic surgeons are required to utilize a licensed anesthesiologist – and, the knowledge that all anesthesiologists are licensed medical doctors – may alleviate one’s fear of anesthesia. The use of anesthesia, whether a general anesthetic or sedation, is extremely safe, especially with a healthy patient. In any case, this magnifies the need for choosing a qualified, board certified plastic surgeon with experience performing your chosen procedure in an accredited surgery center.  

Fear of complications: In a small number of cases, plastic surgery can result in complications. Very rarely are these complications serious; however, in the vast majority of cases, surgical problems are temporary setbacks that can be remedied with immediate medical attention. All qualified surgeons disclose any and all possible surgical outcomes, from very minor risks to the potential major complications.

Fear of dissatisfaction: Finally, many patients have concern that their results will not meet their expectations. This is normal, and even healthy. After all, those with unrealistically high expectations (i.e., “this surgery will change my life”) are often not good candidates for plastic surgery because surgeons call into question their mental stability. To relieve yourself of this fear, ask to view before and after photos of your surgeon’s past patients. Chances are, you will feel better knowing that others have attained a result you admire. But most importantly, be certain that your surgeon listens to you and clearly understands your goals.

As stated, a small amount of anxiety about surgery is healthy. You can be a good candidate for your procedure by understanding the risks involved, researching all potential outcomes, and then remaining optimistic that your surgery will go smoothly – like the vast majority of cosmetic surgeries do.

Illegal plastic surgery is on the rise throughout the United States, especially in areas with concentrated immigrant populations. Often, these procedures are performed by unlicensed physicians and result in the death of the patient, such as in these cases:

• Dr. Peter Normann, an emergency room physician who had never received plastic surgery or anesthesiology training, was convicted in 2011 of second-degree murder for the deaths of Ralph Gonzalez, 33, Leslie Ann Ray, 53, and of manslaughter for the death of Alicia Santizo Blanco, 41 – all of whom underwent a liposuction procedure at his ill-equipped clinic in Anthem, Arizona. Investigators found that Dr. Normann’s operating room lacked proper oxygen and monitoring equipment, and that his only staff was a massage therapist and a former restaurant worker with no training as medical technicians.

• An unnamed, unlicensed “doctor,” who in 2010 administered silicone injections for gluteal augmentation to aspiring hip-hop dancer Claudia Aderotimi in a Philadelphia hotel room. The 20-year-old patient was believed to have met her surgeon – who is described as a transgender woman in her 30s that underwent gluteal augmentation herself – in an online chat forum for people interested in plastic surgery.

• Brazilian doctor Luiz Carlos Ribeiro, who performed liposuction, rhinoplasty, and Botox injections for three years in Framingham, Massachusetts. He primarily kept his business afloat by offering the services at a discount to the town’s large Brazilian immigrant population. The procedures were performed in the basement of a Framingham condominium basement. In 2006, Ribeiro, his wife and the owner of the condo were arrested and charged with manslaughter, unauthorized practice of medicine, and drug counts.

• In the same town, the 2011 death of a 39-year-old Brazilian housecleaner after getting breast implants from Dr. Sanjeev Sharma, raised eyebrows about doctors that are board certified in specialties other than plastic surgery performing cosmetic procedures. Sharma was board certified in family medicine, but not in plastic surgery.

As you can see, at least two of these cases involved individuals who were, to some extent, trained as doctors. However, they lacked the proper qualifications and facilities to perform cosmetic surgery procedures. Therefore, they are criminals who performed illegal plastic surgery.

For that reason, the importance of finding a board certified plastic surgeon has never been more pressing. Make sure your doctor is certified by the American Board of Plastic Surgery (ABPS) before you commit to undergoing any procedure.

I frequently explain to patients that their health is of great importance when it comes to qualifying for specific procedures. Often, it surprises them to learn that age is not nearly as big a factor. 

As featured in a news video clip on huffingtonpost.com, a 75-year old, Sherri Cook from California, received breast implants and underwent breast lift surgery at the office of board certified plastic surgeon Michael Niccole, MD. She told the Today Show, “You know, I always tell my husband that I think older women all end up looking like oatmeal boxes or matchsticks and I don’t want to look like either one of those.”

Cook’s story may seem uncommon, but one statistic reveals that in today’s culture, it is anything but rare. According to the American Society for Aesthetic Plastic Surgery (ASAPS), nearly 85,000 people who are ages 65 and older chose to surgically enhance their appearance in 2010. Procedures like breast augmentation are more popular among seniors than ever, and procedures typically thought of as “traditional” for aging adults, i.e. facelift surgery, continue to attract patients.

Many mental health professionals are in support of the trend. Psychologist Belisa Vranich told NBC that, “We shouldn’t be surprised that seniors are willing to go under the knife to preserve their looks. Things are different these days. Seniors are much more active than they used to be. Our seniors are getting divorced. They’re dating. They’re competing in sports. Why not plastic surgery to go along with how young they feel inside.”

As stated, health is the primary factor when determining any patient’s candidacy for plastic surgery. Dr. Carp will thoroughly examine all candidates to ensure they are healthy enough to undergo any cosmetic procedure. For some seniors, certain medical conditions may prevent them from obtaining the procedure they are interested in. As for patients like Sherri Cook, staying healthy has allowed her to undergo a procedure to help her look as good as she feels.

As the summer months are in full swing, it cannot be stressed enough that sun safety should be of utmost importance when spending any time under the UV rays. According to a report made by the Environmental Protection Agency (EPA), one American dies every hour from skin cancer. Among the most common cancers, skin cancer can be prevented just by picking up one healthy habit – lathering on sunscreen before heading out for the day.

It is crucial before going to the beach or heading out to that barbeque to be proactive about your skin’s health.

To help to protect yourself from the sun and help prevent cancer, consider some of these safety tips:

•  Lather it up with some sunscreen: Use a sunblock with at least an SPF-30 before going out in the sun. Also, make sure your sunscreen has UVB and UVA protection.
• Cover up: Put on a shirt, hat, and/or sunglasses to protect parts of the body that are more prone to sunburn.
• Relax in the shade: During the sun’s peak hours (typically between 10 a.m. and 4 p.m.) periodically take a break from the sun in the shade.
• Check the UV index: Before making any outdoors plans, you can check the UV index to find out which times pose the most risk for overexposure to the sun.

Following these simple habits can help protect your skin from sun as well as prevent health risks, such as melanoma.

It is especially important to prevent sunburn, which is the leading cause of skin cancer and premature aging. If you are to get a sunburn, use fresh aloe or cool tea compresses to reduce pain and to prevent peeling.