Liposuction is not a procedure to eliminate obesity, it is an operation that effectively removes locally accumulated fat (lower abdomen etc.). Many people misunderstand this as well as the general public, as well as non-professional physicians.
At the American Society of Plastic Surgery, liposuction is not recommended for people with a BMI index of 30 or more. Such a person must first lose weight with diet therapy. As liposuction for patients with a BMI of 30 or more, the risk of complications (deep venous thrombosis and side effects of anesthesia) also increases, so careful response is required.
If the breast is too large and there are symptoms such as shoulder stiffness, it is common practice to cut out the breast tissue by the method called breast reduction method and then sew the skin again.
However, this method has problems in patients who are planning breast-feeding in the future. Another way that can be considered in such a case is to do a method of first reducing fat-portion of the breast by liposuction and then sewing only the skin of the breast. Feeding breastfeeding is possible with this method.
A facelift is a rejuvenating operation that pulls the slack portion of the face and neck, and excise extra skin etc. Surgery may be a 4-5 hour operation in the case of a full face lift. This operation is generally done in a system where you are hospitalized in a hospital under general anesthesia, but sometimes it is done by local anesthesia as a day surgery outside.
Local anesthesia is not inferior to general anesthesia, and local anesthesia may be safer in some patients. Complications of deep venous thrombosis (so-called economy class syndrome) may occur with long operation surgery. It is said that this is not common in procedures under local anesthesia. The patient is awake and is involuntarily moving his legs.
In Europe and the United States, some patients who have undergone breast augmentation in the past have lymphomas in their breasts and are currently monitoring such cases.
ALCL (Anaplastic Large Cell Lymphoma) is called T cell lymphoma in detail. Unlike the same type of lymphoma that occurs in the whole body, what is associated with breast augmentation is localized to the breast and the prognosis is said to be good. It is a phenomenon only seen in cases using breast enlargement bags, especially on the surface called Textured type more commonly found in grainy breast enlarged bags.
The US FDA has instructed plastic surgeons to inform these patients about such information. In France, there is a debate as to whether to prohibit the use of such breast enlargement bags more seriously. However, since it is a very rare phenomenon at frequent times, it seems that discussion has not been done in Japan either.
Regarding liposuction, our clinic has received various questions from many patients of different nationality.
At this time, we will discuss about slimming surgery using various accompanying devices which are said to be the “latest type” among them. For liposuction, it is famous for its wet method with ordinary cannulas using a tumescent solution that has been widely used in the United States for many years and has established safety. In this method, a local anesthetic or a drug which becomes difficult to bleed is diluted highly, injected so as to inflate the tissue in the target area, and then suctioned. In this method, it is known that bleeding volume is 1% or less of the aspiration volume (very little). Also, depending on the skill of the doctor, it is said that there is little damage to the tissues due to the equipment used, and it is a safe way. In our clinic, using this microcannula method which further evolved this method, effective results with little unevenness are obtained.
Nowadays, in place of the above method, some devices have come up that generate ultrasonic waves and lasers at the tip of the liposuction device. Japanese people are sensitive to new technologies, so treatment using these devices seems to be commonly done in Japan. Then how about in the United States? In the United States, such devices temporarily attracted attention, but it is not being used more often now that it is not used frequently. Why? The biggest problem is the seriousness of complications. Many of these liposuction plus alpha devices emit high energy at the tip, resulting in burns (burns) in the subcutaneous tissue, damage to the nerve, edema due to a delay in the course of healing (water accumulation) etc.
As a result, in the United States and elsewhere, it is true that we have returned to liposuction using a conventional tumescent-based system that does not use lasers or ultrasound.
In our clinic, treatment of migraine is done with botulinum toxin (Botox). This treatment is a treatment method approved by government agencies in Western countries such as the United States, Canada, UK, Australia. Prior to treatment we will check to see if it meets some standards.
First of all, doctors such as neurological department and neurosurgery undergo diagnosis of headaches such as migraine. Then, if possible, receiving image diagnosis such as CT or MRI in the past, it is possible to confirm that there is no abnormality, and so on. At the time of the first visit, if you bring a thing with a history list of medications and a history of treatment up to now, the procedure will be smooth.
For those who are in a season of hay fever or other pollen allergy, although it is unapproved treatment, when improvement is not seen with otolaryngology, taking allergy medicine in ophthalmology, in certain countries a small amount of botulinum toxin is sprayed into the nasal cavity. It has been reported that treatment is effective only by applying to the mucosa.
Most patients are in good condition for a while after being subjected to breast augmentation, but when you want to investigate whether there are problems with breast augmentation bags when it becomes stiff or when you feel a change like a streak (rippling), or that my general symptoms are not good , The best test is MRI study.
Although it costs a little, it is possible to detect bag breakage, leak (leak), degree of capsular contracture, peripheral abnormalities (breast cancer, lymphoma etc.). However, someone with metal in somewhere in the body may not be able to do so so it is necessary to check in advance. There may be cases when you have a tattoo (tattoo) in it.
The American FDA recommends MRI examinations every 3 years for people who have performed breast augmentation, but in reality it seems that there is not one who does so frequently.
Hyaluronic acid and Botox are rejuvenation methods that can be treated easily without reservation, but there are some conditions.
Those who are regularly using vitamin E, fish oil (EPA, DHA, omega 3, etc.), aspirin and other pain medication called NSAIDs have thin blood, so it is easy to get bruised by stabbing the needle, especially hyaluron near the lower eyelid. It is safer to treat it without taking medication for more than a week when considering such an injection.
Regarding Botox, it is said that it is not recommended if you are currently pregnant, or breastfeeding, but it is also said that it is better not to use it even if there is a possibility of pregnancy within the next 3 months from now. In addition, this is for both sexes.
Botulinum toxin such as Botox, and dermal fillers such as Restylane and Juvederm have been used for many years to treat facial wrinkles. Botox is usually used to treat lines between the eyebrows, wrinkles on the forehead, wrinkles in the corner of the eye. The most frequently used filler is the same substance as hyaluronic acid which is also present in healthy skin and its deeper layers, and these hyaluronic acid fillers are usually used in combination with legal and marinet wires and longitudinal wrinkles of the upper lip It is used to correct.
Recently, in the United States, long-lasting hyaluronic acid is used to make the upper part of the cheek plump, and by doing so, the wrinkles of all parts of the face pull to the apex of the bulge It is aiming at the effect of being decreased. This method is called Liquid Facelift in English and is also called a liquid face lift in Japanese, is now a very popular treatment.
Breast augmentation surgery is a wonderful operation that makes a very attractive body line. However, after undergoing this operation, there are things that I have to watch over for years. One is encapsulation or capsule contracture, and the breast implants occurring at a rate of 10-15% are in a state of hardening. If the condition gets worse, it will become a streak that you can understand by touching from the top of the skin, or you can understand it even by just looking at it. When such a condition occurs, it is necessary to remove the implant (breast enlargement bag) and also remove the capsule membrane that is completed.
It will be a larger scale surgery than when breast augment surgery was done for the first time. In general, it will be treated as a hospital admission. On the other hand, if you do not remove the capsule stuck to the breast augmentation bag, you can do with simple surgery if you just need to remove the bag, another complication of water accumulation in the capsule (seroma) also can occurs.
Besides this, damage of the bag (rupture) is said to occur at a probability of about 1% per year per one year. It is difficult to detect this by palpation alone, so image diagnosis such as MRI becomes necessary.
It is said that about 25% of patients who have performed breast implants need to undergo surgery in the future if various other complications are added.
The French government recently warned that it is related to implants used for breast augmentation and specialized lymphomas (undifferentiated large cell lymphoma, Anaplastic large cell lymphoma (abbreviated as ALCL) in English) in breasts became.
Currently it is a very rare tumor and the prognosis is better than the lymphoma that occurs in the whole body so it is not a recommendation for patients who have done breast implants immediately. ALCL is a T cell type tumor called non-Hodgkin’s lymphoma, and there are about 60 cases reported in the world about localized breasts, but it is said that there are more than tens of millions of patients receiving a breast augmentation surgery Because it is so, it is extremely rare.
However, in Europe and the United States there is a system to make information disclosure early and the FDA also keeps monitoring on this subject.
“Fiblast” (Fibroblast) is a human bFGF material developed in Japan and it is approved by the Ministry of Health, Labor and Welfare for use in the treatment of decubitus ulcers (burn ulcers, lower leg ulcers) in the plastic surgery field.
Recently medical institutions of beauty medical care have used this material out of approval. Even in our clinic, patients receiving a subcutaneous injection of this substance at another clinics come and complain “lumps” of the injected sites. It is difficult to remove a lump caused by subcutaneous injection of fibroblasts and removal is difficult even with invasive treatment. I think whether it is better to pay attention to subcutaneous injection of the fibroblast material that is used for non-approval use.
Regarding PRP, the substances derived from your own blood, it is necessary to submit a third category registration on regenerative medicine by the Ministry of Health, Labor and Welfare, and I think that some approved medical institutions can still do such treatment. However, it is recent general opinion that the sustained effect by subcutaneous infusion as said earlier can not be expected.
We are using only Swedish Restylane and Juvederm made in France, which is approved as a subcutaneous infusion in the Ministry of Health, Labor and Welfare. Even if problems arise, there are degradative enzymes, and it is rare to cause permanent lumps and the like.
Many of the tattoo removal is done using laser, but if you do not do some pretreatment (anesthesia) then it will be accompanied by a considerable pain.
In our clinic, pain is relieved by using anesthetic cream or a method of injecting local anesthesia. In the case of anesthesia cream, please think that pain can be reduced in 40-50%. On the other hand, in the case of local anesthesia, it becomes painless. The needle used for local anesthesia uses a very fine needle imported from the United States.
Which anesthetic method is better, you can choose from those two. If you would like to take tattoos but are not good at hurting, please do not hesitate to consult us.
The director of our clinic came to Japan from the United States back in 2005. Just ten years ago I gave a lecture on safe hyaluronic acid therapy etc. to the doctors as a lecturer at a seminar on beauty care procedures such as hyaluronic acid. At that time, there was a report that there was already high risk of injection of hyaluronic acid-containing injections into the surroundings of the eyebrows in the United States.
There are few small arteries that are dominant in the vicinity of the eyebrows, and there is no supply of blood flow from the other side with side chains to each other (the end- artery). When injected material enters such a blood vessel, surrounding tissues die (necrosis). Also, since the artery around the eyebrows is located close to the arteriovenous of the orbit (in the dent of the eye), multiple examples in which the injected substance enters the eye artery for reflux to cause blindness It has been reported.
In the case of hyaluronic acid, there is still an enzyme agent that dissolves it, but there are cases where it can not be saved with other injectables, especially those of semi-permanent type.
The same problem may actually occur not only in the glabellar region but also anywhere in the center of the face. There are several technical key points when injecting subcutaneous infusions such as hyaluronic acid, and for those who do not master it, these risks are even higher.
In general terms, I think that treatment of these subcutaneous infusions should be done by specialists (board-certified dermatologists or plastic surgeons) who are familiar with cosmetic medicine (also attending academic societies) doctors. At our clinic, we explain the possible dangers to patients when treating that part, and we are doing the treatment.
Dr. Kure is the only US board-certified plastic surgeon in Japan.
Regarding the pain accompanying the treatment, we use various methods to alleviate the pain used in the United States, we try to treat less burdensome.
Even when using local anesthesia, for example, special pain medication is used to minimize the pain of the injection itself.
In addition, we use Japanese made ultra fine needle. Even in the case of hyaluronic acid injection, it is also possible to treat with almost painless by using nerve block anesthesia according to your request
About 10 years ago when we began preparing the clinic in Japan, we inofrmed on the safety of subcutaneous infusions such as hyaluronic acid in the US at a lecture meeting for doctors, but at that time I have mentioned the serious complications of blindness and skin necrosis many times.
In the United States some of these complications had already been announced.
Although hyaluronic acid itself is generally a safe dermal filler, it is rarely happened that there are events in which facial blood vessels become clogged due to treatment to the vicinity of the eyebrows and nose.
Although highly skilled technique is required for such injections, hyaluronic acid still has some medicines to dissolve it, but in many cases it can be reduced somehow, because there are no such drugs for permanent type of infusions , It will be a serious consequence when a problem occurs.
In our hospital, we do not use it as injectable material except for hyaluronic acid made from USA or France or autologous fat.
Hyaluronic acid is a type of polysaccharide and its basic chemical structure is the same as that originally found in human skin.
Because the force to attract moisture is strong, even a small amount of treatment may cause expansion effect beyond injection volume.
However, since the nasolabial lines formed after many years are deep subcutaneously deeply contained like a scar, it may be difficult to completely eliminate this with subcutaneous injectables.
Although I look at the situation with injection of about 1 cc usually, it can be said that the nasolabial lines should improve according to the injection volume.
It is extremely rare that unexpected swelling occurs by injecting hyaluronic acid.
In that case there is a possibility of allergic reaction (which is said to be very difficult in theory).
In some cases it may be necessary to inject an enzyme agent that degrades hyaluronic acid.
More commonly seen are “lumps” and “bruises”, but the lump is easy to get out or not in relation to the hardness of hyaluronic acid used and the thinness of the skin at the injection site.
Regarding bruises, if you are taking medications or supplements that have blood-thinning action (Vitamin E, fish oil, aspirin, etc.), those who came to treatment after stopping them for more than one week It is safe.
If that is not the case, I think that big bruises will not happen often.
Before applying hyaluronic acid injection, apply local anesthetic cream to the area to be treated and wait for a while before treatment.
This will relieve pain considerably, but if you prefer treatment that is more painless, block anesthesia may be given.
There is little chance of facial nerve paralysis when injecting Botox into the jaw muscle, but it can occur rarely.
If it happens, the left and right difference of facial expressions will appear. Even if paralysis occurs, it will fully recover in the future.
Since Botox has not confirmed safety during pregnancy and lactation, it can not be used during these periods.
Botox itself is a safe formulation and rarely has side effects, but the side effects caused by the relationship of the injection site include eyelid ptosis (eyelid lowering) and eyebrow ptosis.
It occurs with a probability of 1% or less in the treatment of the eyebrows and forehead, but it surely recovers.
Next, symptoms such as headaches, fatigue, and a common cold are rare as those occurring regardless of the injection site.
In rare cases, facial nerve paralysis may occur due to injection into the jaw muscles.
It costs 3,000 yen + tax for the name of the initial registration fee.
Approximately 1-2 times a month is required to show your progress.
This is because OBAJI is a medicine, so it will not work well without a doctor’s guidance.
It depends on the symptoms.
There are 5 to 6 bottles in Obagi’s kit, but our clinic does not use all of them from the beggening.
First of all, when you look at the condition of your skin, for example, if only spots are a problem, you start with two kinds of medicine that rejuvenates skin called tretinoin and whitening medicine.
In this case tretinoin is 7500 yen plus tax, even if whitening medicine is added, it will settle at the 20,000 yen level.
If you have used OBAGI before, even if you want all the kit, it is about 53000 yen (+ tax) at maximum.
This price depends on the clinic.
Improvement in acne, spots, pores, blemishes, and it has lifting effects and so on.
There is also an effect on the melasma (stain of symmetry on the cheeks).
Instead of cutting it, make a double line with a smaller needle and thread than on the eyelids.
The results of the DST method of double eyelid surgery is durable.
There is also a method to fix with just one thread in a simpler way, but there are times when it can lose the created lines.
Three points are fixed by the DST method.
This DST technique is also used to correct the sagging skin of the Caucasian upper eyelids.
Odaji of a pharmacy is “cosmetics” and “Obagi” sold at a clinic is called “Obazi · ZO” and categorized as “medicine”.
There is no major swelling compared to cutting.
Many people get swollen in 4 or 5 days, but some people take more than 7 days.
(3-4 weeks when cutting off), the shower is OK from the next day, makeup is OK from the 2nd day.
This non-cutting upper blepharoplasty can be used for Caucasian people as well.
There are individual differences in the cycle where hair grows, but it is generally 4-6 weeks.
If you are going to book next time, if you are a type of hair growing up well, you can do it after 4 weeks, otherwise it is fine even after 6 weeks.
Also, if you still have not been able to grow even after 4-5 weeks, you can change your reservation by phone (to postpone later).
Who will perform laser hair depilation treatment? Because I want to treat bikini line, I do not like men …admin : 2017年9月12日 1:15 PM : Laser hair removal
At our clinic, after the doctor makes an inquiry (a brief consultation), female nurses who are qualified therapists will be doing the treatment.
It seems that laser hair depilation of estheties often takes 10 or more times to treat, but is there a difference in effect between the equipment in the clinic and the esthetic?admin : 2017年9月12日 1:12 PM : Laser hair removal
Our depilation laser is an American-made FDA approved “medical laser hair removal device”.
This device is very effective and powerful, but it can not be used unless it is a medical institution.
On the other hand, what seems to be called a laser in what is used in many esthetic salons, it is often “light therapy equipment”, the output is also weak, and it is more than doubled times (medical laser If it is 5 times, I hear that it is often necessary to have more than 10 times on esthetic equipment.
Also, basically hair removal is a medical practice, so if you interpret it by law, depilation with esthetics will be illegal if there is no supervisor of the doctor there in Japan.
If you already have a sunburn, hair removal is not recommended basically.
This is because pigments in the treated area may spatulate or deposit.
Especially, in the case of the lower limb (knee), it may come out like a zebra pattern.
Basically there are risks in the case of the face, but in the event that it is absolutely necessary, after considering the risk sufficiently, there are also possibilities on consultation with the doctor, so please consult us.
There is no problem with sunburn after depilation treatment, but after treatment, please check that there is no redness or swelling.
However, sunburn needs to be recovered before the next treatment.
In our clinic, we will offer you services to everyone, for the first time we offer two designated body areas (listed on the website) at half price.
Also, since it is possible to recalculate if the density or area of hair drastically decreases after the fourth time, please consult the staff.
Also, if you are going to do extensive treatment at more than three locations at once, there is a special discount system separately (from the third treatment), so please consult us.
Our laser equipment is approved for depilation of all skin types in the US FDA.
The laser beam emits energy by identifying the black or brown hair.
The closer the skin color and hair color is to the skin, the more likely it is burns.
To prevent this, we change the wavelength of the laser (100 ms) or drop the output, but it is still easy to cause burns, so a cautious treatment plan is needed.
I have to treat laser hair depilation once and move to another country, but is it worth getting treatment?admin : 2017年9月12日 12:54 PM : Laser hair removal
Laser depilation at our clinic/hospital is an American-made medical laser device, and even one treatment can expect a considerable reduction of hair color.
Hair removal effect requires further treatment due to hair cycle, but please be assured that any laser equipment in other countries will be effective further treatment.
The effects of laser hair depilation vary greatly among individuals and can not be said unconditionally, but in general, dramatic hair loss effects can be expected with 3-4 treatments.
This means that there are 3 phases;
1. hair growing now on the surface
2. There is also hair under the skin
3. There are still hair that is still asleep as saying hair.
Therefore, three or more treatments are needed at intervals of 4-6 weeks to treat hair of all cycles.
After that, from the thinner hair to the hair-growing state, until there is no more complete, there are individual differences, even if it is several times, sometimes many times, hair reduction may not be done more than the hair-growing state.
This is due to factors such as hair color, thickness, strength of hair root.
In either case, I think that if you treat 3-4 times, I think that you will understand the general direction of how effective it is.
I think that laser therapy should be avoided during pregnancy as well as American FDA guidelines, as a general theory.
This is due to the fact that the effect of the laser on the maternal body during pregnancy has not been sufficiently investigated, in addition to changes in physiological phenomena such as increased sensitivity of pain, emotionally unstable, etc.
Is it better for hair to be shaved before treatment for laser hair removal? Should I come un-shaved?admin : 2017年9月12日 12:44 PM : Laser hair removal
In our medical laser, we can expect sufficient treatment effect after shaving hair.
Although it may seem to be “that” when there is experience of depilation with esthes etc, many of the instruments of the esthetics are weak in output with “light depilation equipment”, stretching the hair, with hair There are times when you take the method of “baking”.
Medical laser has very high specificity to hair, high output, it can expect sufficient treatment effect even if the hair does not grow, (less hair) and less pain.
However, if you withdraw with wax or hairdressing, you can not treat until you come back to some extent.
When I get a job I must put out tattoos, but I do not have much time (about half a year). I heard that it may take about a year for laser. What should I do?admin : 2017年9月12日 12:40 PM : Tattoo Removal
If it is 6 months, I think that it is possible to treat 5 times with the interval of each laser treatment being 6 weeks.
However, if you are not able to remove it after five treatments, as a matter of embarrassment, there is also an option for cutting (ablating) and cutting.
Although it is thought that the skin graft is another option, please consult with a doctor as it becomes a method that remains “permanent scar” even if it is any.
Although our medical laser hair removal equipment has been approved by the Food and Drug Administration (FDA), the FDA uses the expression “Permanent Hair Reduction” for permission, which means that the effect of laser treatment is different depending on the skin quality and the color of the hair.
For example, in the case of Caucasian with dark black hair or Japanese, when enough effect is obtained by 4-6 or more treatments, it is often that you can expect such effects as being almost permanent.
However, with thin hair such as brown hair, there is a possibility that further epilation is difficult from the hair-growing state or it will come back thinner in the future.
In that sense, the expression “permanent hair reduction” is used.
Usually the scab can be taken within a week and a flat surface appears.
Thereafter, a light brown color change may occur in the area where the laser hits.
It gradually becomes less noticeable over a few months.
In rare occasions the treated area may be raised somewhat.
If these changes are noticeable, we may refrain from further treatment.
Before treatment of tattoos, we apply anesthetic cream (included in treatment costs) or injection of local anesthesia (actual cost: 1,000 yen ~).
The use of cream alone can reduce pain, but those who want to treat painlessly have an option of injection of anesthesia.
There are at least four factors related to laser tattoo removal.
Color, thickness, depth, skin strength etc .. Regarding color, if red and black, it is almost always possible to remove almost by repeating the number of times.
On the contrary, green, pink, purple and others are difficult to completely remove.
If it is a tattoo where most of these colors are occupied, it may be realistic to cut out (cut) or shave.
Even with black tattoos, thick pigmented tattoos require more treatment. Laser is destroying the top layer only every time.
For depth, for example, shallow pigments that amateurs put in tends to be easier to remove than dyes that are much deeper.
Finally, although it is the strength of the skin, it is sometimes the case that the laser is irradiated, the skin after the treatment rises unevenly.
Even if you use the laser at discreet power in such a case, there may be marks on the skin.
In actual treatment, we decide comprehensively the above things and decide the optimal treatment plan.
There are several factors such as the thickness and depth of the pigment and the kind of color in the easiness of tattoo removal, in some cases it may be inconspicuous by several treatments, and in rare circumstances the case where it takes longer than 10 times to become thin Yes.
For example, in the case of black and red tattoos about 5 x 5 cm in size, the initial treatment cost will be 30,000 yen, consumption tax will be applied.
If the 2nd and 3rd rounds still remain, the same cost will be incurred, but if the treatment area needs to be reduced when 4 or more treatments are needed, re-measure the area and discount it To go.
In addition, between treatment and treatment generally you need to wait for more than 6 weeks.
For treatment of migraine with botulinum toxin (Botox etc.), it is subject to insurance treatment in Europe and the United States, if a patient has no abnormality with MRI etc, a definite diagnosis by a headache expert such as neurology internal medicine is made. These people are being treated with peace of mind at almost all specialized medical institutions.
In Japan, it is unauthorized as an insurance treatment, so the doctor’s decision is left to the discretion, but our clinic’s guidelines are similar to those in the West. However, if local treatment is desired with mild migraine, we will also conduct partial treatment on a trial basis, so please consult us. In that case, the treatment cost is from 20,000 yen.
Dr. Robert K. Kure opened his practice back in year 2000 in Beverly Hills, CA, then in midtown, New York City 2 years later. He moved to Tokyo, Japan in 2005, and opened the current practice in 2007. This is the 10th anniversary in Tokyo.
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