I appreciate the gift of life for all my patients who wonder how we develop additional surgical skills!

If you ever wonder if your surgeon maintains up-to-date skill development, you can rest assured that I am constantly in a mode of article review and surgical science participation. In order to maintain skills, it is sometimes appropriate to refresh one’s ability to review the anatomy of the situation and discuss with other surgeons the most current and up-to-date methods of achieving the best outcomes possible. Of course, there are certain host factors associated with healing and outcome. However, the surgeon who is constantly evolving methods of improving outcomes is to be appreciated. It has been my sincere pleasure to participate in a surgical symposium where we can have an open forum of surgical discussion and then go to the anatomy lab to discuss and perform surgical procedures using new techniques.

These techniques would be impossible without the exploration of skills of the very selfless people who have donated their bodies to science in order to facilitate the learning and development of new techniques. Those who have donated their organs have a special place in heaven for me, as my brother has benefited from the gift of life in a successful heart transplant at Vanderbilt University. He has a new lease on life in every way after being on the precipice of leaving our world because of his cardiomyopathy.

That being said, I have the most significant appreciation for my ability to participate in the anatomic exploration of new techniques with other innovators at the forefront of surgical outcomes. As a medical student, It was my personal motivation to pursue Plastic Surgery as a career so that I could continue to innovate using the known and emerging principles of Plastic Surgery, biochemistry, wound healing, physiology, and anatomic knowledge to innovate in order to achieve the best outcomes possible for patients.

A heartfelt “Thank you” from one surgeon! I am sincerely grateful to those of you who read this and are contemplating the donation of your organs and body in the pursuit of scientific endeavor. You’re part of the medical profession in constant pursuit of improvement in humanity’s plight and the mitigation of suffering with your selfless gift.

By: Dr. Paul Vanek

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Aging causes lengthening of the upper lip skin, reducing the visible mucosal surface. Loss of subcutaneous fat flattens the lips and reduces the definition of anatomical landmarks such as the vermillion border, Cupid’s bow, and philtrum columns. This thinning combined with the repetitive movement of the orbicularis oris muscle results in “lipstick lines” or vertical rhytids emanating from the vermillion and extending onto the white upper lip skin. The skin is further thinned by degradation of elastin and collagen fibers which occurs with aging, and women have thinner soft tissue in the perioral region compared to men.

Hyaluronic acid fillers are commonly used to improve lip volume and to sculpt and define the vermillion and philtral border as they flatten with age. Filler placed between the skin and the orbicularis muscle provides improved skin structure and support to the upper lip. Filler should not be placed in the orbicularis oris muscle as the muscle houses the labial vascular supply, risking intravascular injection and subsequent necrosis. Neurotoxins, while they help weaken muscles causing lines, are detrimental to upper lip rejuvenation, as they do nothing to improve skin structure and may exacerbate elongation of the upper lip. Injectable agents do not shorten the elongated upper lip. Surgery, such as a lip lift to shorten the vertical skin in this area, may be a good adjunctive procedure.

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“A VISIA Complexion Analysis is an eye-opening, objective analysis of skin health,” says Dr. Paul Vanek. “It blows patients’ minds that the different components that affect the appearance of their skin can be objectively measured with spectral analysis.”

The VISIA is a skin health evaluation tool that helps Dr. Vanek develop a custom skin care and rejuvenation plan that is individualized to your needs.

“We incorporate the VISIA analysis right at the beginning so we can set objective metrics to measure the success of the treatment programs we propose,” says Dr. Vanek. “It only takes about 20 seconds to complete a scan. Patients are often surprised by the results because it makes them see their skin in an entirely new way. But, they love that it’s objective, that we can propose and proceed with a treatment path, re-scan, and judge the success of the treatment in a purely objective manner.”

How It Works
The VISIA uses multi-spectral imaging to highlight six key areas of concern: wrinkles, spots, pores, color variation/vascularization, bacteria population and sun damage. The results of the imaging are visualized, detailed and compared against a database of over one million scans allowing you and Dr. Vanek to quickly see how your skin health currently compares to the population. The ability to see and identify problematic areas in your skin’s complexion allows Dr. Vanek to suggest treatment options for prevention and rejuvenation.

“We recently had a 46-year-old woman come in to have shallow and deep acne scars on her chin evaluated. She’s of Eastern European decent, grew up in Arizona and recently moved to Mentor, Ohio. She wasn’t surprised that results of the VISIA showed she had oily skin, but she was taken aback that she’s in the lowest quintile for skin cleanliness as defined by a bacterial count of her pores,” says Dr. Vanek. “Based on the results, we did deep-cleanse exfoliations and a glycolic peel to treat the porphyrins (bacteria in the pores) and the Mentor Peel℠ to improve the appearance of her acne scars. After three months, we re-scanned her with the VISIA, and it objectively proves what she sees in the mirror: her fine-line wrinkles and scars are diminished, her pores are smaller, and her bacterial count is down. She’s experiencing fewer and fewer episodic acne breakouts, her skin looks clearer, and she couldn’t be happier.”

Complimentary Analysis, Always
Because of the VISIA’s ability to set objective standards, Dr. Vanek offers complimentary VISIA scans to all of his patients.

“You will always be offered a VISIA analysis. There’s no charge. Even our patients who come in for non-skin care related treatments have the opportunity to have the condition of their skin objectively evaluated.”

As a double board-certified plastic surgeon who has been practicing aesthetic medicine since 1996, Dr. Vanek can offer a variety of treatment recommendations to match your goals and anatomy. During the consultation, Dr. Vanek will be able to explain the risks and benefits of treatment paths in a forthright way so you can make an informed, medically sound decision.

“Give us a call if you are interested in improving the condition of your skin, in the New Year” says Dr. Vanek.

It sounds like you may wish to have a consultation to discuss your options to improve the appearance of your tired eyes. As we age the muscle around the eye sags, and the fat pads that cushion the globe protrude, giving a tired, unrested appearance.

Sun and fun, with aging gives us wrinkled skin that worsens the look we enjoyed when we were younger. There are no creams or fillers that refresh that particular combination of aging changes. If your physical examination confirms this, you may be a candidate for an outpatient procedure called lower blepharoplasty. The procedure involves some anesthesia in your vein to keep you relaxed as an outpatient procedure. There is a fine line incision that is placed at the lower lash line and a suture is placed directly under the skin. The fine line scar is imperceptible in appearance once healed. The suture slides out on day 7 after surgery. With our current Zoom life, most patients who are seeing their own tired under eye bags in the camera can have a very refreshed result in a few weeks after surgery. You may drive, shower and walk a mile the day after the surgery.

Because my practice focuses on facial rejuvenation you may have your upper lids and brow surgery performed at the same time to refresh your entire upper face. A natural, rested look is the goal. Patients correctly are afraid of having an “operated look” or un-natural look. When the lay person sees an unnatural appearing media-personality with altered appearance, it makes our whole society shudder. I will review photographs of patients who have generously shared their before and after results at different times from surgery, to demonstrate to you the pathway you will be on in my practice.

I have found that actual videos of patients and how they move and appear are the most powerful demonstration of the natural result of any facial rejuvenation result in my hands. You will have opportunity to review these with me at the time of your consultation. I will review your after-care instruction in my office before your surgery. After your procedure you are advised to avoid contact lens use for about 2 weeks, and use drops and ointments 2-3 weeks to moisturize your eyes. Once your incisions are healed, I also include lasering the scar to make it the least perceptible. This happens in your follow-up appointments at months 2,3, and 4 after the surgery. I will follow you for years after any procedure, and it is all included in your surgery fee. If you don’t like your eyelid appearance and are ready to explore your options for improving your tired under eye bags or unapproachable look, then call my office for a consultation.

I have video tapes of eyelid incision closure at the time of surgery on my website gallery. Click here to view.

Please visit MentorPlasticSurgery.com photo gallery on eyelid surgery for more photos of patient results
you’ll love!

Clearly the removal of fat from unwanted areas leads the most popular procedure in plastic surgery. But since we are in the age of camera-ready social media, boomers are proudly proclaiming ’60 is the new 40. Of the 17.7 million cosmetic surgery procedures performed in the US in 2018 (the most recent data), 23% were performed on those 55 and older.

Facial rejuvenation, Filler injections, eyelid lifts, liposuction and breast augmentations are leading areas of concern and procedure frequency in the US. Radio-frequency body contouring with non-surgical technique called Trusculpt ID, which tightens and tones the body areas of concern.

These surgical and non-surgical techniques have high popularity and patient satisfaction remains high. Increasingly patients who have had minimally invasive injections with off the shelf items like Restylane, Juviderm and RHA fillers are turning to board certified Plastic surgeons for more long-acting biologic agents- their own autologous fat grafting to plump up their lips, lines, breasts and faces. The fat from the tummy or thighs are harvested with a little local and then the fat is processed in the office or OR, then placed immediately in the target area. This can be readily combined with eyelid surgery. The incision in the crease of they eye can be done as an office procedure, or require light twilight anesthesia to refresh the upper face.

Very popular with men who are competing in the work force with younger co-workers, this procedure has skyrocketed in the era of Zoom awareness of one’s tired appearance. Zoom work culture has made many people take note of their tired under-eye appearance. Simple solutions for the under eye tiredness may be the addition of a little filler in the naso-jugal fold. More severe under-eye bags may need an outpatient surgery called lower blepharoplasty to give a more long term and natural, rested appearance. Breast augmentation popularity and frequency remains high.

Innovation in the use of internal support for the implant using Galaflex, Alloderm and Strattice biological materials has made the results more long lasting and predictable. As you are contemplating your beauty goals for the upcoming year, come in and see me at Mentor Plastic Surgery & MedSpa so we can talk over your pathway!

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I have been happy with wrinkle control Botox, but more recently my brow position is getting slumped. What should I do?

You may be experiencing brow ptosis. This is defined as the lowered position of the brow and forehead laxity that comes with genetics, sun damage, age, and sometimes the dosing of your Botox or neurotoxin of your choice. I first need to examine you to determine what is going on. We will review your injection experience and perhaps recommend a lower dose of the neurotoxin you may be receiving in your frontalis muscle, the muscle that elevates your brow and contributes to forehead wrinkles. If the lower dose lets you compensate, then the problem is solved for a time. But if your examination shows slumping of your brow in the outer rim of your orbit, you may be a candidate for a one-hour procedure that repositions your brow through three 1 inch incisions, called an endoscopic brow lift. This long-lasting procedure restores your upper facial eye brow position, it relaxes the crows feet around your eyes, and it takes away the hooding between your eyes (over your nose) in a way that Botox, Juveau, Dysport, and Xeomin cannot. The appearance change is very natural, and involves very small incisions in your hair, that allow me to restore your youthful appearance with a 5 mm endoscope! You don’t need your hair shaved. You can shampoo and style your hair the next day. The incisions usually heal in about 10-14 days. Your softened upper face looks well rested, not surprised. You can resume most business activities in a few days after surgery. While bruising is possible, there are no incisions around the eyes for endoscopic brow lifting, unless you wish to remove the under-eye “bags” the same day, or you have a lot of excess upper eyelid skin. If you look in the mirror and like the appearance you see when you softly raise your eyebrow with your fingers, and see that your nose bridge looks less tired and grumpy and your face looks more rested. If this is your desire, you can contact my office and arrange for a complimentary consultation to evaluate what’s going on. We will discuss the options, and perhaps use some digital imaging to show you how you will look with your new look. I will show you gallery photos of patients who have undergone this revolutionary procedure! Merry Christmas to my readers!

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What is the state of the art for body contouring?

After we get up from our Thanksgiving celebration, there is a tendency to reflect upon our good fortune, our family, and our waistline! If you are experiencing hard to lose areas of your body, you may wish to address them with some lifestyle modifications to see if they improve with that effort. But some body areas are stubborn reflections of our genetics and life events like childbirth, that nagging knee injury that precludes the same amount of cardio, or just not enough hours in the day.

If you are inclined to seek improvement in your body shape, then you may wish to call for a consultation for body contouring. The gold standard mommy make over (or dad bod make-over) is a lipo-abdominoplasty, which combines the technology of Vaser ultrasound and helium plasma Renuvion. These technologies are selective to reduce fat in areas of the thighs, knees, abdomen, flanks, back, buttocks, and love handles. A 4 mm incision is created to instill a little IV fluid mixed with local anesthesia, so that when your treatment is over you are comfortable. The Vaser probe is passed under the skin, selectively reducing the fat in a permanent way.

The results are smoother body areas, tighter skin, and a thinner you! Because the elasticity of skin is one of our problems as we age, Renuvion energy has been shown to tighten areas that have had fat removal by liposuction technique to improve overall contour and stimulate a more youthful appearance.

The Renuvion technology is also passed under the skin at the time of Vaser use to further optimize the surgical outcome. These technologies are combined in my practice with other more advanced techniques like tummy tuck, face lift, buttock lift, arm lifts and Brazilian Buttock lifts. If you are interested in improving your body contour, and have been frustrated with your current situation, it is time to give my office a call to start your journey! My staff and I welcome your inquiry and will teach you about your options for body contouring in the coming year! We at Mentor Plastic Surgery & MedSpa are thankful for your support of our practice!

Ultrasound energy is a wavelength that can be used externally to “see-through” the tissues and let us determine anatomic detail. Its most prevalent use is to see babies in utero and measure growth progress, including a heartbeat, facial features, and hand formation from as early as 6 weeks of gestation! This same energy is now available to guide a needle into the body to place anatomic blocks of local anesthetics to help you recover from tummy tucks and breast augmentation surgery. The TAP block and PEC blocks are incorporated into my practice at the time of surgery so that when you wake up from the procedure you are moving more freely and comfortably. This lessens your narcotic use as well as makes you generally feel better in the most critical 1-2 days after your procedures.

Another state-of-the-art use of ultrasound waves is with Vaser liposelection. This liposuction technique uses sound waves created by a crystal handpiece that is sterilized and used in the operating room. The crystal handpiece is connected to a sterile titanium 3.9 mm probe, which is passed under the skin allowing the sound waves to break the fat cells selectively. In the areas of unwanted fat, as well as unwanted male breast tissue [called gynecomastia] this selectively and gently pops the fat cells like a water balloon. Because it is selective, it preserves the nerves, blood vessels, lymphatics, and collagen, which allows you to recover more quickly with less blood loss, numbness and swelling, and bruising. Older techniques are hollow cannulas that indiscriminately rasp away everything under the skin. We only need to treat the fat- which is why Vaser is the state of the art for liposuction. The Vaser Ultrasound also stimulates more “shrinkwrap” of the areas treated. I participated in clinical studies as a scientific investigator studying Vaser compared to other techniques. Our multi-center study demonstrated that VASER energy had 53% more shrinking of skin than hollow cannula lipo, and also showed 23% less blood loss. Our study scientifically concluded that Vaser has better tightening, less blood loss, and less bruising and pain than older methods of liposuction.

Another area of research in my past at Cal Berkely, Lawrence Berkely laboratories was in the biological effects of radio waves and microwaves on human cells and wound healing. Since then, the use of radio waves to activate helium gas came into the market to treat and tighten human skin and subcutaneous tissues. This energy is called Tesla energy and is delivered at the time of liposuction with Vaser to further improve body contour and tighten skin in all areas. I utilize Vaser ultrasound and Renuvion radio wave energies at the same time in the operating room and in the office to selectively improve body contours. These state-of-the-art body contour modalities are available at Mentor Plastic Surgery & MedSpa. They can be done with tummy tucks, arm lifts, thigh lifts, or breast reshaping surgeries to enhance your shape and improve your outcome. Single areas can be performed in the office with a little ProNox gas to keep you happy during the awake procedure.

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The most effective methods of treatment for fat and muscle definition involve radiofrequency waves and multi-directional muscle stimulation and their effects on the different tissues of your trunk, abdomen, flanks, thighs, arms or buttocks, even chins. TruSculpt Flex and TruSculpt iD can combine to rock your abs and make you look more toned and firm as well as strengthen your muscles and reduce your fat. Trusculpt Flex tones and tightens your muscles. Trusculpt id permanently shrinks your fat and shrinks your skin if your weight stays the same. Each treatment takes about 45 minutes in the office. Depending upon your fitness level and B

BMI we do the fat treatment areas using up to six treatment zones in a single session. We usually wait about 6 weeks between fat treatments in your target areas. While you’re waiting for the fat to shrink, your skin will also tighten. During this waiting period, you can start the 4 to 6 sessions of the Flex treatments. Trusculpt Flex can be done twice a week and this will produce muscle toning and definition. Most patients are a candidate for treatment for this treatment, although there are some contra-indications. During the consultation, you will be evaluated to see if you are a good candidate for non-surgical improvement. If your goals are more extensive or you have too much laxity, then you may need to consider surgery. You don’t need to be a bodybuilder to benefit from hard-to-lose areas toning, or hard-to-shape areas slimming. People who don’t work out a lot can see some nice results. For those that are already in good shape, there are great sculpting effects that can occur because of the effects of radiofrequency waves on your tissues. Unlike freezing methods, the radio waves tighten the skin while it shrinks your fat.

You won’t get bigger fat in the areas treated with radiofrequency energy like seen in up to 20% of fat freezing treatments. It really works! The treatment has no recovery time and enables you to return to immediate normal activities after treatment. With the Trusculpt Flex, some people experience muscle soreness after the multi-directional stimulation of the muscle groups that replicate intensified twisting, squat, and crunch actions. In addition, the muscles are contracting and stimulated to the point of exhaustion, then relaxing occurs to increase strength and enhance endurance. The fast, deep, sequential contractions of the muscles simulate interval training to increase basal metabolic rate and define the muscle mass.

Give us a call and schedule a consultation. Whether it’s a bathing suit or a board room, you’ll look better!

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Beauty trends are always changing, but a good set of brows never goes out of style. Throw in the fact that, when wearing a mask, our eyebrows are one of the main features, and you’ll see why stellar eyebrows are one of your biggest beauty must-haves of 2021. Rather than spend hours of precious time plucking, penciling, and obsessing over your brows, perhaps it’s time to consider something else. If you want to make sure your eyebrows are always on point, a surgical brow lift might be in order — this endoscopic minimal incision procedure is long acting- lasting for over a decade, it takes one hour to perform, and is affordable compared to a decade of Botox that doesn’t raise your brow position or solve the concerns of droopiness around the eyes the way brow repositioning does. The patient who decides brow surgery is for them usually sees eyebrow hooding, unhappy face, tired face, or angry appearance. They may or may not have social feedback that reinforces that internal narrative that they “don’t look happy.” A brow lift can often be performed at the same time as upper or lower eyelid surgery. Often, elevating the brow to its rested, relaxed position improves the appearance of the excess skin of the upper eyelid enough to not have to do anything else!

The one-hour surgery called endoscopic brow lift is an innovation over older methods, in which the incision is placed from ear to ear in the mid-scalp. Instead, a 5 mm endoscope is placed under the scalp line through 3 tiny incisions covered by your hair. We won’t shave your head! The incisions heal in about 3 weeks, so those who color their hair should do it before surgery. For men looking to take some years off their face, the incisions are readily covered by a baseball cap or letting your hair grow out a little bit to comb over until you are healed. The brow elevation is natural-looking, the 11’s lines between the eyes are gone, and the brow muscles and sensation are normal after you recover. You can resume heavy exercise and contact sports in about 3 weeks. Because it is a minimally invasive, endoscopic procedure you may return to work in a few days. My staff and I will show you photographs of real patients who allow review of their recovery to let you know about how it will go for you. Our photo gallery of before and after pics will let you carefully decide what works best for you. I can morph your image to show you how you will look post-op.

Regardless of what specific goals or resolutions you’ve set for yourself this coming year, we hope that your 2021 is rejuvenating and filled with hope! If you’re hoping to grow your confidence by trying a new plastic surgery or aesthetic treatment this year, we are here to guide you along the way.