Abdominal Irregularities after a Tummy Tuck in Oxnard: One Year After Surgery

A few days after seeing another surgeon's patient, who was unhappy with a painful abdominal bulge one week after a tummy tuck, into my office walks in another dissatisfied 45-year-old tummy tuck patient from Oxnard--but she is one year after her surgery.

I had a tummy tuck approximately 12 months ago.  My upper abdomen is perfect, but, right underneath my belly button on the right side, there is a bulge.  I have no idea what this is from.  Is it a weakness in my muscles?

The potential causes of this irregularity are different one year after surgery than they are immediately after an operation....

• inadequate fat excision or liposuction at the time of the surgery (which is an artistic error)
• inadequate or asymmetrical skin excision (which is also an artistic error)
• muscular weakness (either because the stitches used to tighten the muscles came loose or because recent weight fluctuations re-stretched out the muscles in some areas)
• chronic seroma (which is a benign fluid collection that never fully resolves on its own)
• organized hematoma (which is the scar that replaces an undrained blood collection)
• organized fat necrosis (which is the scar that replaces dead fat cells)

In most of the above circumstances, repeat surgery is required to correct the complication.  However, a mini-abdominoplasty approach is usually adequate, and the full incision does not usually need to be reopened.

A Hair Tonic from California that Really Works?

The FDA has agreed that Latisse helps eyelashes grow longer, thicker, and fuller.  That probably sounds great to my female readers, but what most guys are wondering is, "How will it work on my bald spot?"

I have a couple of female patients who have used Revitalash (containing the same active ingredient as Latisse--bimatoprost) on thinning hair with impressive results:  greater numbers of thicker hair follicles.  I'm still waiting for a male patient to give Revitalash (or Latisse) a try on his scalp.

While Revitalash has never received an FDA approval for any indication, Latisse can be marketed legally only for eyelash enhancement.  So, you probably won't be seeing advertisements for Latisse replacing those for Rogaine or Propecia.

However, if I were a manufacturer of one of these two products, I'd be nervous.  I'm already anxious for my colleagues that do hair plugs to treat male pattern baldness; they might soon be out of jobs!

Latisse, Revitalash, & Marini Lash: You Can Grow Your Eyelashes Longer

Mascara may not be the only thing that you'll be using to enhance your eyelashes.  New products truly lengthen and thicken your eyelash hairs.

The story of these miracle drugs begins with glaucoma patients in the eye doctor's office....  Glaucoma is a disease of elevated eye pressures, which lead to nerve damage and blindness.  A new class of medications known as prostamides was developed to lower eye pressures.  Patients recognized a fortuitous side effect; the prostamides also grew eyelash hair.

(Unfortunately, these prostamides also tended to darken patients' irises, which are the colored portions of the eye.  Blue eyes were turned hazel; hazel eyes were turned brown.)

While none of the prostamides have become first-line glaucoma treatments, their popularity surged.  Patients demanded prescriptions so that they could apply the medications to their eyelid margins!

A number of my colleagues frequently acquiesced.  I even know physicians who pre-printed prescriptions for Lumigan, the most popular prostamide.

Entrepreneurs then diluted Lumigan and packaged it specifically for eyelash enhancement.  Age Intervention and Revitalash were the first, and both have shown great efficacy.

(However, because of purported patent infringements, the makers of Age Intervention have ceased production.  Their replacement product Marini Lash does not contain bimatoprost and is likely not effective.  Revitalash may soon suffer legal action as well.)

Now the original manufacturers of Lumigan have developed their own proprietary eyelash enhancing product:  Latisse.  It is the only prescription treatment that has been formally approved by the FDA to grow eyelashes longer, fuller, and darker.

Like the other eyelash enhancers, Latisse appears to be easy to use, but patience is required.  It is a once-per-day treatment that you apply topically to the base of your upper eyelashes.  Most patients start to achieve results within a month.  More than three out of four patients had longer, fuller, and darker eyelashes at the four month mark.

Because Age Intervention and Revitalash were never FDA approved, there are no good scientific data evaluating their efficacy and safety.  Anecdotally, my patients have been thrilled with both products, especially Revitalash.  Most people do get at least some result, and side effects have been few.

Because of the scientific rigor of Latisse's evaluation, I can write with much more certainty regarding its safety profile.  Patients should not use Latisse if they have an active eye condition, including an eye infection, or if they have broken or irritated skin on their eyelids.  If patients have glaucoma or are being treated with eye drops for excessive intraocular pressure, they should use Latisse only after consulting with their eye care specialist.

The most common side effects from Latisse are minor--itching sensations and redness.  Less commonly, Latisse has been associated with eyelid skin darkening, eye irritation, dryness of the eyes, and redness of the eyelids.

Because Latisse has been better studied, expect it to cost more.  While I have been selling a bottle of Revitalash (which should last 4-6 months) for $150, the manufacturer's suggested retail price for a bottle of Latisse (just enough for 1-2 months) is $120.  With more experience, I'll let you know whether the extra dollars are justified!