January, 2012 | Dr. Forley
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Archive for January, 2012


Sunday, January 29th, 2012
TUMMY TUCK 36 year old female following 3 C-sections

36 year old female following 3 C-sections

Extra fat or loose skin around the abdominal area can be a persistent problem that does not respond to diet or exercise. When combined with muscle weakness after pregnancy or weight loss, surgery may be the most effective solution to improving the appearance of your tummy. Two procedures to consider are liposuction or abdominoplasty (tummy tuck). Here, we discuss which one may be right for you.


Many factors can affect the contour of your abdomen. Excess fat deposits can produce undesirable bulges or fullness. Childbirth can stretch abdominal muscles to an extent uncorrectable with exercise. Loose skin following childbirth or weight loss can result in an unattractive surface appearance of the abdomen.

TUMMY TUCK 4 months following tummy tuck

4 months following tummy tuck

Abdominoplasty, known as a tummy tuck, is a procedure that improves the contour and appearance of the abdomen by tightening or reshaping the underlying muscle framework and removing excess fat and loose skin. If fat deposits are the only contour problem, they may be correctable with liposuction alone. Muscle that shifts laterally as a result of pregnancy will remain there and creates a weakness that prevents you from attaining a flat tummy. It cannot be returned to its proper midline position with exercise. After significant weight loss, your abdominal skin may become much looser, and sometimes actually hang downward, creating a pleating effect. Skin does not respond to any type of exercise, and similar to stretched muscle, will require a tummy tuck to remove the excess. How much your abdomen can be reshaped depends on several factors. The quality of your tissues is very important and is variable amongst patients. If you are significantly overweight, you’ll get a much better correction if you achieve a more ideal weight before your tummy tuck. To reshape the underlying muscle-based support framework and remove excess skin, incisions are necessary. The length of the incision placed just above the pubis depends on the amount of loose skin correction you require. Any necessary incisions will produce scars. The quality of these scars depends on several factors including your specific healing characteristics. However, most patients view the scars as a worthwhile trade-off for the significant improvement that can be achieved in the shape of the abdomen.


TUMMY TUCK 30 year old female prior to surgery

30 year old female prior to surgery

Age, heredity, and hormonal factors can sometimes counteract our best efforts to attain the type of physical appearance we desire. Even in individuals who are not overweight, localized deposits of fat can occur in areas of the abdomen, producing undesirable contours. Liposuction alone can be used to treat the fat when muscle and loose skin are not contributing to the problematic appearance.

Careful assessment prior to the procedure will determine if this is the right procedure for you. First, you must look at your skin. If it does not hang and it snaps back when pinched then you can expect it to contract well after fat removal. When you inhale and tighten your abs, you will be able to determine the contribution made by the fat under your skin to the bulging of your tummy. When you exhale, the added prominence that results is due to muscle laxity. The difference between the two is what can be treated with liposuction.

TUMMY TUCK  5 months following liposuction of the abdomen

5 months following liposuction of the abdomen

Small incisions are used to insert narrow tubes or cannulas to suction away the unwanted fat. Remember, liposuction is not designed as a weight reduction procedure, but as a technique to blend body outlines more aesthetically. Surgery needs to be combined with a program of fitness and nutrition to achieve and maintain long lasting results.

During your consultation, Dr. Forley will advise you as to the best treatment options to enable you to achieve the appearance that you desire.

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Saturday, January 14th, 2012

What is a laser?
A laser is a wavelength source of high-energy light that is accurately focused and transmitted onto a very small area of the skin. The light travels in one direction, heating the skin selectively based on the wavelength and energy settings of the laser. In some cases, the skin is vaporized with an ablative laser when wrinkles are more severe. Current lasers such as the Fraxel re:store Dual and the Fraxel re:pair are precise and selective, allowing treatment of wrinkles, pores, brown spots, acne scars, and sun-damaged skin.


Ablative vs. Nonablative
There are two kinds of lasers: non-ablative and ablative. Non-ablative lasers, such as the Fraxel re:store Dual, work beneath the surface skin layer, using two wavelengths to deliver energy in “fractional” zones of heating with every microscopic treatment zone surrounded by unaffected skin. By maintaining the integrity of the surface layer of the skin, the downtime is kept to a minimum with this type of laser. Ablative lasers, such as the Fraxel re:pair, provide deeper dermal remodeling of more severely sun damaged skin by heating and vaporizing the treatment zones using fractional carbon dioxide (CO2). Both approaches stimulate collagen growth, improve skin tone, and decrease fine lines and skin discoloration. During your consultation, Dr. Forley will discuss which laser will work best for you.


Treatment and Healing Expectations
Topical numbing cream is applied for 1 hour prior to the treatment to decrease skin sensitivity. During the laser procedure, cold air is used on the skin, making any discomfort manageable but pain medication can also be used if desired. A sedation or “twilight” type of anesthesia may be indicated when an ablative laser is used. A full face treatment takes about 30 minutes.

Fraxel re:store Dual laser treatment produces a variable amount of redness and swelling over the first 3-4 days and dryness and flaking will occur throughout the first week. You are able to return to routine activities within 3-4 days but must use sun protection. Benefits are most evident with three to five treatments, spaced every 4-6 weeks.

Fraxel re:pair laser has a more involved recovery period and requires the area of treatment to be kept moist with gauze soaks and ointment for 5-7 days. The skin will be red and may be covered with a fine crust. Pinpoint areas of bleeding may also occur in the first 48 hours. The treated sites must be protected from sunlight after the procedure. In some cases, a pink surface color may remain for several weeks. You are able to return to routine activities and use make-up after 7-10 days although concealer may be necessary. Often, one treatment is all that is required to achieve the desired result.

Areas of Treatment

The Fraxel re:store Dual laser can treat wrinkles, acne scars, surgical scars, age spots/sunspots, melasma and actinic keratoses. The Fraxel re:pair laser is used for advanced sun damage and wrinkles, irregular texture, and age spots/sunspots. Laser treatment is not a substitute for a facelift nor can the procedure eliminate excessive skin or jowls. However, when combined with surgery, laser resurfacing can enhance the outcome of a facelift by improving skin quality.

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