Micro-Needling, the new craze people in the beauty industry can’t get enough of, and for good reason. Micro-Needling is an innovative technology that creates controlled micro-injuries to stimulate the body’s natural wound-healing process while minimizing cellular damage. The result is effective remodeling of scar tissue while keeping the overall structure of the skin intact. This is a safe, highly successful, way to fade scars, stretch marks, wrinkles and sun damage without downtime. That is if you get services done by a professional who uses the correct device. 

At Maxwell Aesthetics, we use SkinPen® – which is the only FDA approved device clinically proven to safely and effectively treat facial acne scars. 

All other devices are not a cleared Class II Microneedling device and should not be used for treatments. Sadly, not all spas and medi-spas invest in such a device. This is why we wanted to educate our patients about the importance of making sure you know what device is being used regardless of where you get your Micro-Needling services done. By getting services done at a practice who uses SkinPen® you are assured of the following:

1. First globally approved device with CE Mark and ISO 13485:2016 Certification
2. Clinically proven to be safe and effective
3. Cartridge validated for needle quality, sterility, and precision
4. Protects the patients and delivers clinically proven results
5. Designed and engineered in the U.S.A. with proprietary technology

For more information please visit SkinPen® website: https://skinpen.com/

When you had your implants placed, you may have been given a small wallet-sized card with the make and model of implant.

For any patient that had their implants placed at Maxwell Aesthetics within 10 years, we have the records of all breast implants place on file. If you had your implants placed greater than 10 years ago, we still may have your record. Please call us so we can let you know what type of implant you have. If you did not have your implants placed at Maxwell Aesthetics, you should contact your surgeon or hospital/surgery center where your implants were placed and ask for your operative report. Usually, there is a medical records office or administrator who will be able to retrieve the report.

Textured Allergan implants affected by the FDA statement are all from Allergan include;: Natrelle Saline-Filled breast implants

Natrelle Silicone-Filled breast implants Natrelle lnspira Silicone-Filled breast implants

Natrelle 410 Highly Cohesive Anatomically Shaped Silicone-Filled breast implants

What symptoms are seen with BIA-ALCL?

 The most common symptom is breast swelling that occurs after one year post textured implant placement. It may or may not cause pain. The average time for the swelling to occur in patients who have BIA-ALCL is 8 years after placement. Other symptoms that can occur include a lump found in the breast or in a lymph node in the armpit. While swelling or lumps should prompt a medical evaluation, this does not always indicate BIA-ALCL. There may be other benign reasons for these symptoms.

How do we test for BIA-ALCL?

If you have textured implants, the FDA recommends routine medical care and follow up including mammography when appropriate. If you have any swelling in the breast or lumps in the breast or armpit, please contact our office for an evaluation to determine if you should have an ultrasound imaging exam performed. Currently, there are no screening recommendations for patients with textured implants without symptoms.

If you have swelling and there is fluid around your implant seen on an  ultrasound,  a  sample  of the fluid can be collected with a small needle and sent for a special BIA-ALCL pathology assessment. We know there are specific markers on BIA-ALCL cells called CD30 that can be tested to make a diagnosis. iv

What if I have textured implants but do not have any symptoms? Should I have my implants removed?

Currently, the FDA does not recommend removing textured implants in patients without symptoms. While this is a broad statement, it is my opinion that each patient should be assessed and have a treatment plan for their individual medical care. There are several factors including capsular contracture (firmness around the implant), peace of mind or other reasons that removing textured implants may be the best option for you. If you feel this may be your situation or if you have any questions to better help you make an informed decision, please schedule a consultation.

What is safe if I remove my implants? Can I have an additional non-textured implant? Am I a good fit for a breast lift?

Briefly, yes – other non-textured implants can be placed (gel or saline) and a breast lift may be a good option as well. Each patient will have a variety of factors to consider in order to individualize their best treatment plan.

I just received a BIA-ALCL diagnosis from a sample of fluid that was taken from my breast, now what?!?

The first step is to remember to breathe! There will be a lot of information to process and it can be overwhelming. Some positive news is that BIA-ALCL is a very slow cancer. There have only been 12 reported deaths in patients with BIA-ALCL from the 573 cases in the United States. It is curable.

Schedule an appointment immediately with Dr. Maxwell and let our scheduler know you have a confirmed diagnosis. We encourage you to keep a journal/diary and write down all of your questions as there will be many. It can be very challenging to recall important questions you have while meeting with your surgeon or other physicians.  It is also very important to have a family member or close friend join you at appointments for both support as well as helping remember and process all of the details of your treatment plan.

Patients with a diagnosis of BIA-ALCL that is limited to the capsule surrounding the implant and does not go beyond this boundary (the majority of new diagnoses) can be cured with a total capsulectomy and removal of the implant. Dr. Maxwell has a tremendous amount of experience with the total capsulectomy and implant removal procedure and has pioneered surgical techniques to ensure removal of the complete capsule in even the most difficult cases.

Chemotherapy is not needed unless there is very rare, advanced disease that is well beyond the existing capsule surrounding the implant into the lymph nodes or far from the breast.

I like to be a well-informed patient, what are some reliable resources you recommend?

 While there is a lot of misinformation on the internet, there are also excellent sources that can provide additional accurate and up to date information.

One such site, which is maintained by the American Society of Plastic Surgery:

www.plasticsurgery.org/patient-safety/breast-implant-safety/bia-alcl-summary

An additional website that can help answer some of the questions regarding the Allergan textured implant warranty:

www.allergan.com/biocellresources

While this is a lengthy post, there is a lot of information to review. If you have any questions, points of clarification, or would like to be evaluated, please call Maxwell Aesthetics for a consultation at 520-751- 1225. If you have found this Q&A to be helpful, please share it. It is important that accurate

information is shared to help those affected by the textured implant recall and raise BIA-ALCL awareness.

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i www.fda.gov/news-events/press-announcements/fda-takes-action-protect-patients-risk-certain-textured-brea_st­ implants-requests-allergan

ii https://allergan-web-cdn-prod.azureedge.net/actavis/actavis/media/allergan-pdf-documents/biocell­ replacement-warranty.pdfi

iii www.fda.gov/medicaI-devices/breast-implants/medical-device-reports-breast-implant-associated-anaplastic­ large-cell-lymphoma

iv Current Risk Estimate of Breast Implant Associated Anaplastic Large Cell Lymphoma in Textured Breast Implants.

Collett DJ, Rakhorst H, Lennox P, Magnusson M, Cooter R, Deva AK. Plast Reconstr Surg. 2019 Mar;143:30S-40S

v Breast implant-associated anaplastic large cell lymphoma, a systematic review and in-depth evaluation of the current understanding. Ebner PJ, Liu A, Gould DJ, Patel KM. J Surg Oncol. 2019 Aug 1

vi The Epidemiology of Breast Implant-Associated Anaplastic Large Cell Lymphoma in Australia and New Zealand Confirms the Highest Risk for Grade 4 Surface Breast Implants. Magnusson M, Beath K, Cooter R, Locke M, Prince HM, Elder E, Deva AK. Plast Reconstr Surg. 2019 May;143(5):1285-1292

vii ASPS and ASAPS BIA-ALCL Advisory Update www.surgery.org/sites/default/files/BIA-7-31-18.pdf

While choosing your plastic surgeon is important, having the peace of mind that the whole team is of the same high standard is also important to achieve the best outcomes. At Maxwell Aesthetics, we have utilized the same American Board of Anesthesiology certified Anesthesiologist for the last 15 years. Together we have developed a strong team and refined our approach to providing a gentle anesthetic experience while minimizing side effects and maximizing the restorative potential of our procedures.

In the Kardashian-era of beauty standards, it can be hard to keep up with the ‘perfection’ that comes across our Instagram feeds. We scroll endlessly through retouched photos and forget that the images we see don’t represent reality in the slightest.

Even the women we look up to for their amazing style and shatter-proof confidence are popping their photos directly into Photoshop to enhance their bum before the world gets to see it.

We’re all for women looking and feeling their best. At Maxwell Aesthetics we believe that women should be free to enhance their bodies in any way that makes them feel beautiful, but not at the expense of their physical or mental well-being.

Some medical procedures to enhance the appearance of the body are safer and more effective than others. That’s why we want to have an open and honest conversation about the risks of the popularized procedure called the “Brazillian Buttlift”.

This procedure essentially entails the surgeon removing fat from one area of the body and grafting or redistributing it onto the patient’s buttocks.

First, it is important to realize that often times social media photo-editing enhances the appearance of this procedure even more than a doctor could realistically (and safely) help a woman achieve. But beyond the misleading advertising that surrounds this procedure, there are some serious and long lasting side effects that can impact the patient.

Some of those side effects are less dangerous and include severe bruising and excessive stretch marks. More concerning though are the risk of infection, blood clotting, fat embolism (when fat enters the bloodstream and travels to the lungs), necrosis of fat (cells dying prematurely) and more.

The list of risks for this procedure is growing and there is an increased number of women dying from complications from the Brazilian Buttlift. We recommend doing extensive research before undergoing this procedure.

If you have any questions or concerns regarding cosmetic plastic surgery, you can trust Dr. Maxwell and our staff. We always have your best interest in mind and put self-care and safety above all else.  

Everyone deserves to feel comfortable in their own skin. Each individual person has their own way of achieving confidence and happiness in their physical appearance. It is becoming increasingly common for women to take their appearance into their own hands, seeking the help of professional hands. When diet and exercise alone haven’t been enough to make someone truly satisfied with their look, it may be worthwhile to explore cosmetic surgical intervention.

Breast augmentations are the most popular cosmetic surgery. Research performed by the American Society of Plastic Surgeons states that 300,378 breast augmentations were performed in 2017. In the last year, the number of breast augmentations performed increased by 3%. These procedures are becoming more affordable and come with less risk than ever before.

If you are considering a breast augmentation, it is critical that you choose a doctor and medical facility that is the best in their field and makes you feel completely happy. That’s why we know that you will love your experience with Maxwell Aesthetics.

Our experienced staff understands and relates to your most intimate concerns. Maxwell Aesthetics also offers complimentary Breast Augmentation consults with Dr. Maxwell’s highly trained clinical staff.

When you choose to work with Dr. Maxwell you can experiment with implant sizes and see your before and simulated after photos, including 3-D images. This takes the guesswork out of the process and ensures you will get a result you love.

Here’s what you can expect during your one hour consult:

• Learn about Dr. Gwen Maxwell and the Practice
• Gather information about the procedure
• Photos and 3-D Vectra Imaging
• Try on various implant sizes and profiles – wear your favorite t-shirt and bring a bikini top
• Learn about profile differences, along with Saline and Gel implants
• Estimated quotes will be given (not valid until approved by Dr. Maxwell)

Following your consult, if you are interested in moving forward with a Breast Augmentation procedure with Dr. Maxwell, we will schedule your 30 minute complimentary Re-Consult with her (appointment must be within 6 months from your first consultation appointment).

CALL US TODAY TO SCHEDULE YOUR COMPLIMENTARY
BREAST AUGMENTATION CONSULTATION
(520) 751-1225

Who is the Ideal Botox Candidate?

Let’s face it, everyone has at least one stubborn wrinkle they would love to make disappear. Perhaps it’s on the forehead or a permanent memory of all the laughter you have had in life. Take the time to learn about the ease of Botox injections and diminish those lines. Experience a refreshed and natural look.

Any healthy adult, male or female, wanting a more youthful appearance is a candidate for Botox. Muscles can be relaxed, resulting in diminished wrinkles and frown lines creating a softer appearance. We use our facial muscles on a daily basis – smiling, frowning and squinting so it’s natural for lines to form. Botox works by blocking nerve impulses to the injected muscles which reduces muscle activity that causes persistent lines to form.

Patients often mention they get comments about looking tired, angry or unapproachable because of deep set frown lines between the brows. They want to look how they feel inside. Just because they look grumpy or sad, doesn’t mean they are. Botox doesn’t necessarily mean turning back the clock, but can help patients express themselves more positively and confidently.

With real, noticeable results, no surgery and no recovery time, there are many reasons to get treated with Botox. Although the results are visible after 7-14 days, a treatment with Botox will not radically change your facial appearance or make you look as if you’ve “had work done”. It is amazing what it can do for self-esteem and one’s overall appearance.

With results lasting up to four months, Botox is one of the top treatments in many Medi Spas throughout the U.S. Most appointments take only 10-15 minutes and there’s no downtime and minimal to no discomfort.

According to the American Society of Plastic Surgeons, an estimated 7 million injection procedures were performed in 2016, and Botox continued to grow even more popular throughout 2017. No longer is it viewed as a treatment for adults over 45, with a shift in the age of patients asking for Botox. We see patients coming in asking for Botox in preparation of their 25th or 30th birthdays.

Plus, the benefits of Botox injections go beyond just cosmetic. It is often thought of only as a facial treatment for muscle relaxation to soften lines, but it can also be very effective for a condition called Hyperhidrosis. This is excessive sweating of the underarms which results in an embarrassing condition that sneaks up on you in hot summer months, or even when certain people get overwhelmed or stressed out. Botox has the capability of blocking the nerve endings that send messages to the sweat glands which prevents the profuse sweating that people often want to avoid. This is a great treatment for males and females that suffer from Hyperhidrosis and it will last about 6-9 months.

Botox is a drug made from a neurotoxin produced by the bacterium Clostridium botulinum, which sounds scary, but is perfectly safe — if it’s made and administered by a licensed professional. The stigma stating it is a poison simply is not correct. Any fears or preconceived notions should be alleviated by the fact that accredited practices have highly trained and skilled nurse injectors that perform the procedure.

It works by freezing the muscles it comes into contact with, and was initially developed while exploring ways to treat spasms. Botox does not have any long-lasting medical side effects and is essentially a risk-free fountain of youth. It is minimally invasive, and even helps oily skin.

The procedure is ideal for brides, executives, models and fits into any lifestyle. Since there is nearly no recovery time, you can come in have an injection and be back to business that afternoon. With other procedures, there can be bruising and other side effects that can take over a week to heal. Men and women can experience a flawless complexion without the need for surgical enhancement.

Really, anyone is an ideal candidate for injections. Give it a shot and see a younger looking you in an instant. Say goodbye to fine lines, wrinkles, crow’s feet, and more with simple, safe, effective injections.

Why are Explants Becoming More Common?

KOLD News 13 investigates as more and more women are heading back to the doctor’s office to have a common cosmetic surgery reversed.

Some women claim breast implants are causing them to have symptoms such as fatigue, muscle aches, hair loss, swallowing issues and other health concerns. So many of those women are deciding to have Explant Surgery, the removal of breast implants.

Dr. Gwen Maxwell has been in practice for 23 years and has done her fair share of breast implants. But recently her office has seen an increase of explant procedures. In 2013, Maxwell only performed four removals but just last year, the number grew to 40.

“To date there is no scientific evidence to suggest that the myriad of symptoms some women express when they have breast implants really is an actual disease,” Maxwell said. But she describes one way people may be experiencing these issues. She said the tissue in your body produces a layer to protect itself from the implant but sometimes bacteria can get in there and affect your immune system. “It could be that the bacterial foam around the implant sets up a chronic inflammatory response of the body,” she said. Once the implant and the bacteria is removed, explant patients typically say they instantly feel better.

Maxwell said that despite the popularity of the explant procedure, people are still going to her office to get breast implants.

When stubborn fat deposits resist your weight loss plan, liposuction may look like the perfect adjunct to diet and exercise. However, it is agreed upon by many prominent plastic surgeons that while liposuction – a popular and frequently-performed procedure – is effective in reshaping and contouring fat deposits in the body, it’s important to remember that it isn’t a fix-all solution.

It is important to keep in mind, that, while we all should be able to choose to look however we want in our own bodies, that electing cosmetic surgery is a multifaceted decision that shouldn’t be rushed. The success of any treatment is dependent solely on lifestyle choices before and after surgery.

Those who struggle with poor exercise and eating habits that may have contributed to retained unwanted weight will not get good results with liposuction alone. You cannot exercise enough to compensate for poor eating habits – and those eating habits produce the fat deposits within your body. The cornerstone of any change is diet and liposuction alone can’t provide permanent results.

Experts agree, there’s no magic formula or dietary regimen to eliminate unwanted fat, – everyone’s body, needs and lifestyle is unique.

That being said, the first step to changing the appearance of your body is to determine what your ‘healthiest’ lifestyle means for you. If you’re still struggling with unwanted stubborn fat and deposits despite your best efforts at exercise and eating healthily, then liposuction may be a good path to consider. Always remember though, as with any treatment, the procedure varies from person to person, and results will differ depending on the body parts treated.

Following liposuction, you can expect to see visible results – in inches, not abstract numbers. Going into the surgery, it’s important to set realistic goals about the long-term results you expect, and many surgeons recommend picking a weight that’s both manageable and healthy for you, then developing a lifestyle that incorporates good eating habits, good sleep and regular physical activity.

For those interested in pursuing fat reduction, two different options are available: surgical or non-surgical.

New non-surgical developments offer innovative technology that essentially melts or destroys fat through the skin. In a process known as SculpSure, a patented laser is attached to the skin, destroying up to 25% of fat reserves within a 25-minute session. Best suited for addressing small areas, this type of procedure involves virtually no downtime and anecdotal evidence shows that it really is an amazing way for someone to reach their goals.

Surgical options are most effective for larger areas of concern, including removal of loose skin left after extensive weight loss. Most liposuction is performed in conjunction with procedures such as tummy tucks, body contouring, and arm, breast or thigh reductions, which focus on removing the unwanted fatty deposits from those areas.

Even with surgery, recovery time is minimal; usually a weekend at most. The surgery is performed under general anesthesia.

A person’s weight tends to be a very sensitive topic. When exploring choices to attain your goals, no procedure done in a doctor’s office can substitute for diet, exercise, health and well-being. These procedures should be viewed as ‘tidying up’ any unwanted areas that are too stubborn to be moved after the main work has already been completed. Research continually emphasizes that natural-looking, long-lasting results will best benefit from a healthy diet and lifestyle.

Liposuction is an excellent option for those who have established a health first perspective to their lifestyle, but still need a little nudge along the way to help remove deposits that are resistant to change through diet and exercise. Also be sure to check out our new article on the aging of skin and how to prevent it.

Your skin is your largest organ – and the only one exposed for everyone to see. With its complex, multilayered structure, it allows you to interact with your environment and helps you in multiple essential ways. It protects you from dehydration, regulates your temperature, provides sensation, and even produces essential vitamins like Vitamin D.

Skin color and type vary as a result of genetics, evolution and body chemistry. The color is affected by various components, including blood vessels. Carotene can give the skin a yellow color – especially if you often binge on carrots!

Melanin is a colored substance produced by a particular skin cell known as the melanocyte. The amount of melanin varies, producing the extensive array of colors we see in human skin.

Skin color is the result of evolution, based on geographical location. The more ultraviolet radiation skin is exposed to, the more melanocytes it produces. For example, if your remote ancestors dwelt in colder regions, your skin color will be lighter than if they’d originated in India or Africa. The more sun exposure indigenous populations received, the darker their skin colors evolved.

What’s your skin type?

Experts grade skin according to a scale that was developed by a dermatologist. Called the Fitzpatrick scale, it classifies skin types based on responses to ultraviolet light. Physicians use this skin classification clinically to determine programs to rejuvenate and treat aging skin.

Type I   will always burn and never tan                   These patients are fair, freckled and have pale eye color

Type II usually burns, but can sometimes tan      Patients are also fair, often with light-colored eyes

Type III can burn, but will usually tan                       These patients have a light brown skin color

Type IV will tan and rarely burn                                 The skin tone is olive

Type V rarely burns                                                         This skin color is brown

Type VI will not burn                                                      This skin color is black

The Aging Skin

Skin will age in two ways:  intrinsically and extrinsically.  Intrinsic, or “built-in” aging is a component of your genetic makeup.  In other words you will age in a way that is similar to your parents or grandparents.  This is something that’s governed by your genes.  Over time, intrinsic aging will result in loss of the elastic component of the dermis, the dense inner layer below the skin’s surface, and the skin becomes thinner and drier.

Extrinsic aging is the aging your skin undergoes when exposed to environmental factors such as sun, wind and extremes in temperature. The good news? This type of aging is in part preventable and reversible.

When doctors evaluate the skin, they look at multiple factors relating to aging skin, such as laxity or sagging, wrinkles, color, texture, thickness, pigmentation, sun exposure and abnormal growths such as moles or cancers. Patients whose skin type falls within I, II and III on the Fitzpatrick scale will experience more rapid aging of the skin than those in the IV to VI range. If your skin type is within the first three categories, it’s important to be more diligent about preventing sun damage before it can occur.

When it comes to preventing or lessening extrinsic aging of your skin from environmental exposure, the cornerstone of treatment is sunscreen, or sunblock.

Best Practices for Prevention

Sunblock is an opaque substance that will block the absorption of the sun when applied. Two of the main ingredients are titanium dioxide and zinc oxide. These chemicals stay on your skin and are not absorbed, forming a physical block that prevents the sun from penetrating the skin.  If you shy away from gooey sunscreens, take heart: Many newer products whose formulations incorporate these chemicals are more elegant, easier to apply and with a thinner consistency that spread onto the skin smoothly, and are very effective in protecting the skin. They also have the added advantage of not penetrating the skin, minimizing reactions such as rashes or irritation.

Without regular use of sunblock, substantial skin damage from the environment, or “photo-aging” can occur. Sun-damaged skin has damaged collagen, with a resulting loss of elasticity. The skin appears tanned and blotchy, with spots of discoloration and redness from dilated, damaged blood capillaries. Over time, environmental skin damage may progress to a coarse, yellow, waxy appearance, particularly on the lips. Long exposure to sun can result in two common types of skin cancers:  squamous cell carcinoma and basal cell carcinoma.

Second only to using sunblock, applying Retin-A cream to your skin may be the most valuable method to help prevent, delay or treat photo-aging. It contains retinoic acid, essential for normal skin growth, which is lost or diminished with excessive exposure to ultraviolet radiation from the sun. Other products to help combat environmental skin damage include those containing antioxidants, such as topical vitamin C.

Since Retin-A is a prescription-only item, a consultation with a skin specialist is essential to make sure you receive the optimal results from use of clinically effective products. At Maxwell Aesthetics cosmetic plastic surgery center, we provide a comprehensive Skin Care Evaluation and make recommendations based on your degree of photo-aging and individual needs, to create a more healthy and beautiful skin. Also be sure to read about other services that focus on things such as liposuction, tummy tucks, breast augmentation and more.