Surgery Preparation and Follow-up
Preparation for surgery
After the initial consultation and selection of a surgery date, a separate pre-operative appointment will be scheduled. During this visit there will be provided extensive verbal and written information regarding pre-operative preparation and post-operative care. For patients coming from out of the local area, recuperation in a hotel and spa approved by Dr. Ronel can be arranged. Private nursing care from our staff can be arranged as well.
Follow-up after surgery
The surgical fee includes as many post-operative visits as necessary to provide complete medical care. The number of visits and the interval between visits is individualized. Post-operative visits are scheduled to accommodate travel plans for patients from out of town.
Baby Boomer Favorites
Dr. Ronel is quoted throughout. Boomers now make up the bulk of Ronel's practice, and 75 percent of his clients are women, he says.
Cosmetic surgeries look natural, lift spirits, too - Research procedures, have realistic expectations, former patients say -
By Rick Nathanson Journal Staff Writer
For Annie Hawes it was the idea that her mirror image didn't look as good as she felt inside.
Both New Mexico women are baby boomers, one of the biggest and growing demographics undergoing plastic surgery and related cosmetic procedures. The surgeries and treatments are yet another tool available to people who want to remain active longer and look better while they're at it.
Dr. Daniel Ronel, a board certified plastic surgeon with offices in Albuquerque and Santa Fe, says the procedures should be part of an overall plan to improve a person's physical health and mental well-being.
Chew, 63, a Santa Fe stock trader and former nurse, had gone to an optical company to try on new eyeglasses. Photos of her in different frames were taken and e-mailed to her. When she opened the e-mail and saw the photos, she had a moment of "instantaneous realization," she says.
She opted for a lift of her lower face, eyes and brows. "It was such a great face-lift and so natural that people didn't even know I'd had one," she says. "They'd come up to me and say, `You look great, you look rested.'"
Chew says she was mostly recovered after two months, but it took nearly a year for numbness in her scalp to go away completely.
Her surgery cost about $18,000 and wasn't covered by insurance, "but I had a very good year work-wise and felt abundant," she says. "For me it was totally worth it and I would tell others, `If you want it, and can afford it, then go for it.' I would do it again."
"But in the mirror I didn't look as good as I felt. I looked worn. I didn't want to look like a 20-year-old or a Hollywood actress; I wanted to look like me, but a fresher me."
Her surgeries, done within five months of each other, left her "extremely satisfied," she says. "Anyone who wants cosmetic surgery should explore it, research the procedure and look into the background of the plastic surgeon."
Above all, Hawes says, "have realistic expectations and do it for yourself and not someone else."
Accessible to many
There is a perception that plastic surgery is the pursuit of the rich, famous and wealthy, largely because it can be expensive and insurance generally doesn't pay for such procedures, regarding them as "not medically necessary," says Ronel.
There are, however, financing plans, much like buying a car, that have made cosmetic procedures more affordable and accessible to people with modest incomes, says Ronel, who did the surgeries on Chew and Hawes. His clients also include teachers, firefighters, hairdressers, cashiers, construction workers and retirees.
Boomers now make up the bulk of Ronel's practice, and 75 percent of his clients are women, he says.
While breast augmentations and tummy tucks are popular procedures, they are primarily requested by younger women. The No. 1 cosmetic procedure among baby boomers is a face-lift, in which "sagging cheeks and jowls are lifted and tightened."
Other beautification tweaks include eyelid tucks, in which extra skin on the eyelids is removed for a fresher look; and a brow lift, in which "skin above the orbital rim of the eye socket is lifted and tightened."
Liposuction, "the second most popular plastic surgery procedure in the country across all ages," Ronel says, isn't ideal for older baby boomers with looser skin. "You need to have some tightness of the skin in order for liposuction to work. Younger skin contracts and tightens up better, and consequently there's a better outcome with younger patients."
A newer lipo procedure called "tickle liposuction" gets its name from the tickling sensation it gives people as fat is sucked from their bodies. It can be done during a medical office visit without anesthesia and has less discomfort and down time. As a result, it's less expensive than traditional liposuction while offering similar outcomes.
A nose job, or rhinoplasty, must be done in an operating room setting with a patient under anesthesia. Boomers frequently have the procedure because "with age, the nose droops and many people want it lifted back up," says Ronel.
There are nonsurgical procedures using injections of collagen-like tissue filler to correct minor nose irregularities.
Facial injections
Our lips are also subject to aging and get thinner over the years. "Many baby boomers want their lips plumped up, not like the overdone Hollywood lips, but just to get back to where they were before," Ronel says.
That can be accomplished with injections of filler materials, or with an implant such as Permalip, which he describes as "like a gummy worm."
Filler products, such as Juvederm, Radiesse and Artefill, are also injected to fill wrinkles on the face, providing a less invasive and less expensive alternative to a surgical face-lift -- though not nearly as long lasting.
Botox injections can also refresh the face, but not in the same way that fillers do. Botox is purified and diluted botulinum toxin that is injected into facial muscles, causing them to relax, which in turn causes the wrinkles in the skin to relax and smooth out.
"Baby boomers are very big on Botox, but the older you are the less effective it is," says Ronel. "At a certain point, only a surgical lift will work."
New skin
Other alternatives to cosmetic facial surgery include a chemical peel and the "less traumatic" skin rejuvenating laser method.
With the chemical peel, an acidic solution is applied to the face, causing the damaged outer layer of skin to slough and peel off. The new skin beneath it is usually less wrinkled and smoother. Skin rejuvenating laser treatments are best for skin less damaged by the sun, Ronel says. The process uses a laser light to remove damaged outer layers of skin and stimulate the production of collagen and new skin cells in the underlying layers.
"Both are extremely popular among baby boomers, require little down time and are less invasive than surgery," he says.
Chemical peels and some laser treatments, (which are not always "peels"), can be done by certified aestheticians, often under supervision of a physician in a day spa setting. Local spas that offer skin peel procedures include Belleza Med Spa, La Bella Spa and Aquaceros Medical Aesthetics.
Chemical peels are less expensive than laser peels, but people often need more sessions, says Courtney Stone, an aesthetician at Aquaceros.
Many spas also offer Botox injections.
Ultimately, cosmetic surgery is "not just about the size and shape of breasts, buttocks, brows or bellies," says Ronel. Rather, it's about a person's overall health and self-image.
"The most important thing for me is that all these procedures be put into the context of a healthy lifestyle including nutrition, stress relief and exercise," he says. "I want people to feel as good on the inside as they look on the outside."
Especially for Moms
Return often to see the newest procedures to help you feel your most beautiful self as you move through your journey of life with your growing family. You may encounter specific needs. Dr. Ronel is always here with the most recent procedures to address those needs.
Botox for Moms
What is the recovery period for BOTOX?
How long do the results of BOTOX last?
4 - 6 months
How much does BOTOX cost?
There is a wide range, usually $12 - $15 per unit. Most areas of the face require 20 - 25 units. We are always having Facebook and Twitter specials.
Who should perform a BOTOX procedure?
Dermatologists, plastic surgeons, and ENTs are all excellent choices. Surgeons understand the 3-dimensional anatomy of the head and neck, and can manipulate the face more thoroughly than other providers . . . for example, most providers have learned how to treat the furrows in between the brow. I like to go further, manipulating selective smile or neck muscles to achieve subtle results in many other parts of the face.
Who is the Botox manufacturer, or who is the Botox supplier?
Allergan
What are Glabellar lines (frown lines)?
They are vertical lines in between the brows (the 11 ) caused by overactive corrugator muscles, one over each eye.
Where can Botox injections be used?
I have always been fascinated by the different forms medicine can take, as well as symptoms they can treat. No, Botox isn't just for lines, furrows, and crows feet in the face. Botox can be used, not only for physical appearance, but for sweating and migraines as well. Tired, painful feet from contracted muscles behind the balls of the feet can be treated as well.
How effective are BOTOX Cosmetic injections?
It depends on how it is injected and on the area treated: if administered correctly, the results are fantastic and can last 4 to 6 months. If it is given into the wrong skin muscle then it is not very effective, and if it is used to treat a wrinkle that is too deep then it will also be ineffective.
Breast Lift for Moms
Are there risks and complications to a breast lift surgery?
a. There are scars -- every effort is made to conceal or to make them as inconspicuous as possible. Scars may be unattractive and of a different color than the surrounding skin. Scar appearance may vary within the same scar, and may be asymmetrical from one side of the body to the other.
b. There may be delayed healing of the incisions. Some areas of skin may die, requiring frequent dressing changes or further surgery to remove the non-healed tissue.Fat necrosis, or death of fat tissue under skin, may cause firmness, nodules, or contour irregularities. The use of tobacco products (smoking, chewing tobacco, nicotine patch, nasal spray, etc) increases the risk of wound healing complications and additional scarring. Smoking in particular may make recovery from anesthesia more difficult, with coughing and possibly increased bleeding.
c . There may be bruising from blood or fluid collections (seromas) that can last for up to several weeks. These may feel like soft or hard bumps under the skin. Rarely this requires drainage with a needle or more extensive reoperation.
d. It is possible, although unusual, to experience bleeding during or after surgery. The development of a collection of blood under the skin (hematoma) may require reoperation and may delay healing and cause scarring.
e. The nipples may feel numb or may have heightened sensitivity after the surgery. This usually resolves within several weeks, but may last longer and may be permanent. Chronic pain may occur very infrequently from nerves becoming trapped in scar tissue.
f. There may be skin contour irregularities, such as depressions, wrinkling, and residual skin at the ends of the incisions (dog ears) after the procedure. These usually resolve with time but may require minor surgical correction.
g. Deeper structures, such as the ribs, lungs, nerves, blood vessels, and muscles may be damaged during the course of surgery, although this is extremely rare.
h. Blood clots are rare, but may occur after any surgery.
i. Breast feeding may not be possible.
Cosmetic Procedures
Preparation for surgeryAfter the initial consultation and selection of a surgery date, a separate pre-operative appointment will be scheduled. During this visit there will be provided extensive verbal and written information regarding pre-operative preparation and post-operative care. For patients coming from out of the local area, recuperation in a hotel and spa approved by Dr. Ronel can be arranged. Private nursing care from our staff can be arranged as well.
Follow-up after surgery
The surgical fee includes as many post-operative visits as necessary to provide complete medical care. The number of visits and the interval between visits is individualized. Post-operative visits are scheduled to accommodate travel plans for patients from out of town.
Click here to see what you
would look like with Botox or Juvederm!
The Keller Funnel
The Keller Funnel No Touch Technique is a new technique in breast implant surgery that allows silicone implants to be placed through smaller incisions, including the armpit. The funnel is a small bag that looks like an icing bag. Its tip is placed into the incision, the implant is placed into the funnel, and with a little squeezing, the implant is pushed into position. The Keller Funnel allows the implant to be placed without much manual manipulation, which may reduce the incidence of complications.
Look at the picture: do you see the incision hidden in the armpit?
Tickle Lipo
Tickle LipoTM is a safer and quicker procedure than traditional and laser liposuction because it uses small cannulas and low frequency acoustic vibration that does not generate heat, which can damage the skin. The nutational (the motion of a gyroscope) vibration is almost painless and gives the sensation of tickling, or hitting one's "funny bone". The Tickle LipoTM is an out-patient procedure that does not require anesthesia -- patients walk out of the office.
View YouTube video of Dr. Ronel's radio show "The New Tickle Lipo -- In-Office, Less Expensive".
Watch a short video of a patient laughing through her lipo here.
About Tickle Lipo TM Liposuction
Nutational Infrasonic Liposuction (NIL) www.nilnow.com, is well-known in Europe and is the newest method of liposuction offered in the United States, approved by the FDA. NIL has been used in thousands of procedures and has been presented at more than 100 scientific sessions. The procedure offers all of the benefits of current liposuction technology without most of the inherent risks.
NIL safety features: unlike other liposuction techniques that use the heat of laser or ultrasound energy, the surgical cannula used in NIL stays cool, eliminating the risk of thermal injury. The system shuts off automatically when it encounters non-fatty tissue such as skin or muscle. These features enable the physician to safely and more effectively remove deep as well as superficial fat and to perform "high-definition" sculpting.
Additionally, the gentle non-thermal infrasound also allows physicians to efficiently harvest the patient's fat for transfer back into another area, such as facial wrinkles.
Got you laughing? Contact Dr. Ronel's offices to make an appointment today.
Those from out of town can book a weekend at one of Santa Fe's renowned spa resorts to recuperate while they are out enjoying the beauty of the city!
Non-Traditional Adjuncts To Surgery
In addition to the Pre-Surgical Program in Integrative Medicine, Dr. Ronel often uses other non-traditional techniques to improve wound healing, recovery time, and to minimize scarring.Molecular Biology
A modern technique developed from recent advances in molecular biology is the application of platelet gel: in most invasive procedures, such as a face lift or tummy tuck, a blood sample is withdrawn from the patient before beginning the procedure, it is spun down in a centrifuge, and a highly concentrated extract of the patient's own wound-healing factors is prepared. These are sprayed back into the surgical site at the end of the case to improve wound healing and minimize bleeding and scarring.
Pain Control
In many cases, Dr. Ronel is able to insert tiny catheters connected to a small balloon pump through which an anesthetic slowly flows after the surgery. The pain pump works right at the spot of surgery, giving better pain relief than only taking narcotic medications. The small balloon can be worn around the waist or neck. Removing the catheters is painless.
Before & After Photos
There are many web sites available that show pre- and post-operative photos. Because every person's anatomy and process of healing is different, viewing such photographs is only helpful for illustrating changes that can be expected, rather than for predicting a final outcome. Click on any of the procedures to the left for a photo gallery of examples.
Laser Procedures
A Cutera Xeo provides state-of-the-art therapy for pulsed light hair removal and the treatment of skin redness, brown spots, spider veins, wrinkles, large pores, poor skin texture, rosacea and acne scars. Most treatments do not require topical anesthetic.ALL LASER packages include medical grade skin care products at half price.
The Aesthetic Laser Team is headed by Marian Urban of the Sterling Institute. Marian is one of the leading aestheticians in the Southwest, and was instrumental in the development of the specialty in New Mexico. She organized the licensing and credentialing of aestheticians in the state, and trained many of those currently in practice. Marian is the founder and director of The Sterling Institute, which over the past 20 years has developed an international reputation for medical skin care. She is the founder and director of The Medical Spa Professional Alliance, a consortium of aestheticians and physicians. Marian teaches an annual advanced skin care course to aestheticians in Germany, Switzerland, Austria, Italy, and Spain.
Please select a treatment at the left for complete details.
Special Offers
Save 10% off ANY LASER service! Cannot be combined with other offers.Please mention this exclusive web offer when scheduling your visit.
CoolGlide
Vein Therapy For The FaceFor Women & Men of All Skin Tones and Types
Before & After Photos
Now men and women alike are making unsightly facial veins a thing of the past, thanks to the Cutera CoolGlide. No more painful injections! With the most advanced technology, a unique design, and a longer wavelength, the Cutera CoolGlide can safely and effectively treat both tiny superficial face veins on men and women of all skin tones.
The Cutera CoolGlide difference
The Cutera CoolGlide combines the ideal laser wavelength with the most flexible parameters to deliver a superior vascular laser system. It treats a broad range of vessels from tiny spider veins to deep blue reticular veins quickly, safely, and effectively. Patients with dark, light or tanned skin can experience outstanding results with minimal bruising or blistering.
How does CoolGlide Vein Therapy work?
The Cutera CoolGlide systems deliver pulses of light energy which cause the blood within the vein to coagulate, eventually destroying the vessel which is later reabsorbed by your body. Blood flow will then be redirected to veins deeper below your skin's surface, where it should be.
How many treatments will I need?
Often, patients find that one or two treatments are sufficient. However, the number of treatments necessary depends on the number, color, and size of the vessels being treated. Since individual results vary, ask your medical professional about your specific condition.
Do the treatments hurt?
Most patients experience a stinging sensation as the pulses of energy are delivered through the handpiece. Although no local anesthesia or pain medication is typically required, many patients opt to use a topical anesthetic prior to treatment. Following the treatment, the pain is minimal to nonexistent.
What are the possible side effects?
Although many patients report few if any side effects, those most commonly noticed are slight reddening and local swelling of the skin. These effects typically last for less than 24 hours. Some patients may experience bruising and, in rare instances, blistering may occur. Consult with your medical professional for complete information on the benefits and risks of treatment.
When will I see results?
Most patients find that the majority of the treated veins have shown significant improvement within two to six weeks of treatment. However, your final results may not be apparent for several months. Over time, it is possible for new veins to appear, but these too can be removed with the Cutera CoolGlide.
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Laser Genesis Skin Therapy
Treatment of Wrinkles and Redness, Management of Large Pores and Skin TextureBefore & After Photos
Laser Genesis skin therapy is an innovative, technologically advanced way to promote vibrant and healthy looking skin in men and women. Now you can have a youthful appearance by treating those conditions that are typically associated with premature signs of aging and sun damage, such as excessive redness, large pores, uneven texture, and fine-line wrinkles. The Laser Genesis procedure has been scientifically proven to produce new collagen.
The Laser Genesis difference
The Laser Genesis procedure utilizes non-invasive laser technology to safely, discretely and effectively treat fine-line wrinkles, diffuse and excessive redness and help manage large pores, uneven skin texture, and scars. You can expect to see subtle yet consistent results after each treatment, without unwanted side effects such as bruising or excessive skin irritation. Treatments can be performed in a relaxed, comfortable manner without the use of topical anesthetics or gel.
How does Laser Genesis work?
By gently heating the upper dermis well below your skin's surface, Laser Genesis stimulates collagen regrowth. Additional heat is generated in dilated capillaries to reduce redness.
How many treatments will I need?
The treatment results are often subtle. On average, you may require four to six treatments in order to achieve optimal results. Every patient's condition and needs vary. For more information about your expected results or the number of treatments necessary, consult your healthcare professional.
What are the possible side effects?
Although most patients report few if any side effects, the most common is a slight redness that disappears within a few hours of treatment. Consult your healthcare professional for complete information about the benefits and risks of treatment.
What kind of textural improvements can you expect with Laser Genesis skin therapy?
Over the course of four to five treatments, Laser Genesis can help restore the skin's youthful glow and appearance by smoothing out uneven texture caused by aging, sun damage or scars. You will see a more even, healthy complexion as large pores are reduced in size, and minor imperfections are diminished. The individual treatment results are subtle, but the overall effect of multiple treatments can be quite dramatic.
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LimeLight PhotoFacial
LimeLight FacialTMTreatment of Skin Redness, Tiny Veins, Brown Spots and Sun Damage
Before & After Photos
What is the LimeLight Facial?
The LimeLight Facial is a new, non-invasive approach to skin rejuvenation using Cutera's LimeLight. The procedure offers the advantage of improving skin tone and surface imperfections associated with aging and photodamage.
What areas can be treated?
The LimeLight Facial is ideal for any part of your face, neck and décolleté with skin redness, telangiectasia (tiny veins) or brown spots. Light (low contrast) brown spots, which were previously difficult to resolve, respond very well to treatment.
What does the treatment do?
By selecting Program A, B or C, your practitioner can customize your LimeLight Facial to your skin type and selectively treat the brown and/or red pigmented areas on your skin. It's the heating of the pigmented brown or red cells that causes the therapeutic effect.
What do treatments feel like?
When the pulse of light is delivered, patients will experience a mild pinching or stinging sensation. Gel is recommended to cool the skin before vascular treatments. Anesthesia or pain medicine is typically not required.
How long will the treatments take?
Treatment time depends on the area of the body being treated. However, most treatments should take less than one hour.
How many treatments will I need?
One to three treatments are usually sufficient to see results. Additional treatments may be recommended, especially for excessively sundamaged skin.
What happens after the treatment?
Immediately following treatment, brown spots will start to darken and your skin may appear slightly red. The treated area may be mildly swollen. This typically lasts a few hours and possibly a day or longer. Make-up can be applied to cover the redness.
When will I see results?
Within one to three weeks, the darkened spots will flake off and fade. Diffuse redness or telangiectasia will decrease and your mottled complexion will improve.
Will the spots and redness reappear over time?
New brown spots, telangiectasia and diffuse redness may appear with new sun damage; however they too can be treated. Remember to always apply broad-spectrum sunscreen when outdoors to minimize sun damage and the appearance of new spots and diffuse redness. Rosacea is chronic and cannot be "cured" with any laser or light source, however its appearance can be improved.
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Photo Genesis
Treatment of Skin Redness, Brown Spots and Sun DamageBefore & After Photos
Photo Genesis is an innovative way to quickly, safely and comfortably improve your skin's texture, tone and color on your face, chest, arms, and hands, without gel or topical anesthetics. Signs of sun damage and age spots will usually flake off after one or two treatments, leaving clearer, younger looking skin.
The Photo Genesis difference
Comfort. We have created a pulsed light system that is exceptionally effective for treating skin redness (rosacea), brown spots and sun damage at a very comfortable energy level. There is no need to apply topical anesthetic or gel beforehand, and you can realize remarkable results in just one or two treatments.
What does the treatment do?
The visible light delivered by the Photo Genesis procedure is selectively absorbed by the pigmented spots and red areas on your skin. It's the heating of the pigmented cells that causes the therapeutic effect.
What do treatments feel like?
When the handpiece is placed on your skin, it will feel cool and comfortable. When the pulse of light is delivered, you may feel a mild, brief pinching sensation.
How many treatments will I need?
Typically, one or two treatments are sufficient to see dramatic results. Additional treatments may be required for very large or dark spots, densely freckled areas, or excessively sun-damaged skin.
When will I see results?
Many patients see significant improvement within two to three weeks of treatment. Your complexion will be clearer and younger looking. However, your final result may not be apparent for a month or more.
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ProWave Hair Removal
Safe, Fast & ComfortableBefore & After Photos
Now men and women alike are making unwanted facial and body hair a thing of the past - thanks to the Cutera ProWave 770TM hair removal system. No more painful waxing, electrolysis or razors! The ProWave delivers 21st century technology for treatment of this distressing problem. Cleared for permanent hair reduction, the ProWave can treat a wide range of skin types safely and effectively.
The ProWave Difference
The ProWave hair removal system delivers a specially tailored light source for permanent hair reduction. Cutera's newest hair removal innovation provides treatment for a wide range of skin types. An additional patient benefit is the ability of the handpiece to treat large areas such as women's legs and men's backs - quickly and safely.
What do ProWave treatments feel like?
When the pulse of light is delivered, some patients experience a mild pinching or stinging sensation. No local anesthesia or pain medication is typically required; however, some patients may prefer to use a topical anesthetic when sensitive areas are treated.
What are the possible side effects?
Although patients experience few side effects, those most commonly noticed are slight reddening and local swelling of the skin, similar to a sunburn. These effects typically last for several hours or less. In rare instances, blistering may occur. Consult with your medical professional for complete information on the benefits and risks of treatment.
How does ProWave compare with other hair removal methods?
Shaving, waxing, and depilatory creams are all temporary methods which must be repeated on a frequent basis. ProWave offers permanent hair reduction for lasting results.
How does ProWave compare with electrolysis?
Electrolysis is a tedious, invasive, and painful process that involves inserting a needle into each individual hair follicle and delivering an electrical charge to them one at a time. Electrolysis often requires years of treatments at regular intervals. By delivering light energy to hundreds of hair follicles at a time, ProWave effectively treats an area in just seconds that would take over an hour with electrolysis.
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Aesthetician Services
Marian Urban
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