Natural Breast Augmentation in Santa Barbara

Some women who are interested in breast augmentation are weary of the risk that implants bring. While many people tolerate implants with no problem, others may experience infection and/or capsular contracture (when the immune system attacks the implant and makes it distorted) or a number of other issues that implant surgery may cause. The other consideration for those having breast implants is that they will have to face another surgery down the road (about 10 to 15 years later) when the implants need to be switched out. An alternative to breast implants is breast augmentation using the woman’s own fat.

At Cosmetic Surgery Center, our natural breast augmentation procedure does not involve implants. Instead we use the patient’s own fat to create fuller breasts (usually we can go up one cup size). The fat is obtained through liposuction from the abdominal and/or leg areas. The liposuction and re-distribution of the fat is all done in the same surgery. The benefit to using fat is that I am able to choose specific areas to deposit the fat and, by doing so, can correct any unevenness much more precisely than an implant can.

If you are interested in natural breast augmentation in Santa Barbara contact my Santa Barbara Cosmetic Surgery Center office at (805) 563-0000 to schedule a consultation.

Rhinoplasty in Santa Barbara

The latest news in cosmetic surgery from around the world is the duty-free nose job that is now available in South Korea, Asia’s plastic surgery “capital”. Visitors from other countries who get rhinoplasty in South Korea will receive a refund on the value-added taxes (VAT) that are assessed to the foreigners who have the surgery. This is being done to help boost tourism in South Korea and to generate business for the more than 4,000 plastic surgery clinics there. While you could go to South Korea for a nose job, know that there are many other “destination” cities for plastic surgery and my hometown of Santa Barbara is one of the most popular.

As a cosmetic surgeon in Santa Barbara, I have many patients that come from the Los Angeles and San Francisco areas to have cosmetic procedures done such as facial rejuvenation (facelifts, neck lifts, and much more) and body contouring liposuction. Destination cosmetic surgeries are popular for two reasons: it allows people to use their recuperation time as a mini-vacation and, for those wishing to keep their surgery private, the chances of running into friends or family is slim. Since this post is about rhinoplasty (also known as nose surgery, nasal surgery, or a “nose job”), I will tell you a bit more about what you can expect from the surgery – and how you can plan for it if you are making it a destination surgery.

Most people have rhinoplasty to change the appearance of their nose. Nasal surgery can refine a bulbous tip, straighten a crooked nose, narrow a wide nose, and/or remove an unwanted bump. Noses can grow and change all the way through the teen years so the earliest time that I recommend to have surgery is the late teens and any time in adulthood.

General anesthesia is not needed for rhinoplasty. A combination of local anesthesia, oral and intravenous sedation will keep the patient comfortable and unaware. This eliminates the “hangover” of general anesthesia and makes the person feel more like themselves during the first few days post-op. Most people take about 2 weeks off for the recovery and are able to return to work between 7 and 10 days. The majority of the swelling subsides within the first two months, but it usually takes about 1 year for results to be fully realized.

If you would like to have rhinoplasty in Santa Barbara (or another facial rejuvenation cosmetic surgery procedure), it is important to factor in travel time including extra days for the consultation and post-op visits. There are many things to see and do in our seaside town, so you may also want to consider booking extra time to enjoy some of the festivals, museums, dining and wine tasting, and waterfront activities that Santa Barbara has to offer. More information is available on our Guide for Out-of-Town Patients.

All of my clients who have made Santa Barbara their “destination” surgery city have been extremely pleased with the easy-going vibe of our town, the close proximity of our surgical center and medical office to the hotels, and the beautiful surroundings. They have returned home feeling truly rejuvenated both inside and out!

If you are interested in cosmetic surgery in Santa Barbara, contact my Santa Barbara Cosmetic Surgery Center office – at 805.563.0000.

Minimally-Invasive Facelift (Mini-Lift) in Santa Barbara

As a Santa Barbara cosmetic surgeon, I am often asked, “What is the most ‘popular’ cosmetic surgery procedure?” and it interestingly varies by the season of the year. However, one procedure that is popular all year long is a minimally-invasive Facelift (or mini-lift) because it can give most patients a lot of benefit but has less cost and downtime than a full facelift procedure.  It can be done on both men and women and is often suggested when patients have early signs of aging or some recurrence of sagging / laxity following a facelift procedure done many years ago. 

What is a minimally-invasive Facelift? 
A mini-lift addresses sagging and some wrinkling in the lower two-thirds of the face. Some of the deeper fat, muscle, and connective tissues are able to be lifted and tightened. Skin is also removed and tightened. The approach I prefer has many of the benefits of a regular facelift and tends to “last” longer compared to a “suture lift” or purely endoscopic surgeries where tissue is merely “shifted”.  Since there are smaller incisions and less extensive dissection, the result may be less dramatic than a full facelift but it will still be very noticeable and will always be “natural” looking.

Who is a good candidate for a Mini-Facelift? 
The majority of mini-lift patients are in their late 30’s, 40’s or older. Patients should be in good general health but are bothered by signs of aging that are improved when one uses their finger tips to lift the skin in front of the ear canal. As a mini-lift does not deal with the eyes or forehead, those areas remain the same. However, patients may treat problems in the upper one-third of the face at the same time, if desired. 

Is general anesthesia needed for a minimally-invasive Facelift?
Patients are always happy to hear that the minimally-invasive facelift, eye lift or forehead surgery can be very comfortably done using a combination of local anesthesia and oral or IV sedation. This method provides a nice relaxation and lack of awareness throughout the procedure and patients have no “hangover” feeling as is often seen after general anesthesia. 

How would you describe the results of the mini-Facelift? 
The goal of mini-lift surgery (as with any cosmetic procedure) is to have the patient look rejuvenated, rested, and “younger” but not “operated”. Specifically the cheek contour is restored and the jawline is more defined. We always want to have the patient look natural and not “done” … like a younger version of themselves. As we can’t stop the aging process, some relaxation will eventually occur, but the patient should always look better, even as time passes.

Contact my office, Cosmetic Surgery Center in Santa Barbara (805-563-0000), to schedule a minimally-invasive facelift consultation.

Chemabrasion Skin Resurfacing in Santa Barbara

Fine lines, wrinkles, acne scars, “liver” spots (skin discoloration), and saggy skin are all factors that can affect a person’s appearance. While there are aesthetic procedures and physician-grade skin care products that can help alleviate the above issues, the process may take a long time and the results may not be as dramatic as one would hope for. Since I have been a cosmetic surgeon in Santa Barbara for more than three decades, I have seen and worked with many products and aesthetic procedures dedicated to skin resurfacing and the procedure that gives the most optimum result is Chemabrasion.

Chemabrasion Patient “Before” and “After” of Dr. Terry J. Perkins
Chemabrasion is a skin resurfacing treatment that combines a light to moderate dermabrasion (not to be confused with microdermabrasion) with a medium depth chemical peel. This procedure is done in the operating room, but general anesthesia is not required. Instead we use local anesthesia in addition to oral sedation alone or in combination with intravenous sedation. This is sufficient for comfort, relaxation, and unawareness. 
Most people take 7 to 10 days off from work after the procedure. To maximize the benefit of the chemabrasion, post-procedure wound care is an important aspect of the healing process. The skin must be kept clean and well-hydrated to prevent crust formation. Some people experience an initial pinkness to their skin which will gradually lessen in 1 to 2 months. Mineral make-up may be started 8 to 10 days after the procedure. 
The results are noticeable. Wrinkles may be decreased by 70% to 80% and acne scars see about a 50% or greater improvement. It is an ideal procedure to treat skin irregularities, facial wrinkles, acne pits, photo damage, facial scars, pre-cancerous lesions, and early skin cancers. 
Call my office (805-563-0000) – Cosmetic Surgery Center in Santa Barbara – to schedule an appointment to talk about chemabrasion or other cosmetic facial rejuvenation procedures. 

Eyelid Lift Surgery in Santa Barbara

Eyes are often the first thing a person notices about another person. Unfortunately the eyes are also one of the first facial features to show age. The delicate skin of the eye area makes it more susceptible to sun and environmental damage. In addition to that, the loss of collagen – an unavoidable part of aging – results in skin that is less elastic, and prone to sagging and wrinkles. Sagging skin naturally succumbs to gravity. When the eyelids sag, the eyes suddenly become hidden under hooded lids and are surrounded by fine lines and wrinkles, which may make a person appear angry, tired, or older than they are. Fortunately, eyelid lift surgery is an excellent way to restore a rested, youthful appearance.

When is the right time for an eyelid lift?
Some people have eyelid lift surgery in their late 30s while others may do it in well into their 70s or 80s. Most people do the procedure in their 40s and 50s. Some signs that may make you consider surgery include heavy or hooded lids, difficulty applying eyeshadow, and/or when the lids start to obstruct your vision.

Most people do not know that eyelid surgery can address eye issues on the upper lid or under the eye. We refer to the procedures as Upper Eyelid Surgery and Lower Eyelid Surgery, respectively.

Upper Eyelid Surgery 
This procedure addresses the excess/overhanging upper eyelid skin and the inner corner fat bulges. Incisions are made in the natural creases of the eye and are well hidden when healed. A conservative approach is taken to avoid looking “done” and, especially for men, to avoid too much lid show (which gives a feminine appearance to the face).

Lower Eyelid Surgery
Treatment of this area addresses dark circles, fat bulges, and skin laxity under the eyes. Incisions are hidden in the lower edge of the lashes. For those people who have fat bulges, but little excess skin, incisions are made in the inner (eyeball) side of the lower lid. Fat is then able to be removed and sutures are usually not required.

About Eyelid Surgery
Either surgery can be performed under local anesthesia combined with oral sedation alone or together with IV sedation. General anesthesia is not needed. Pain is usually minimal and easily controlled with Tylenol or Ibuprofen. Use of cool compresses and head elevation will help any bruising or swelling subside.

Recovery from Eyelid Surgery
Sutures are in place for 7 days. Returning to make-up and contact lenses usually occurs at 10 days post-op. We recommend purchasing new eye make-up as to not introduce bacteria from old products into the healing incisions. Walking may be resumed the day after the surgery. Most people take one week off from work to rest and recover. Aerobic exercise can usually be resumed at 3 weeks post-op Sunglasses and wide-brimmed hat should be used for all outdoor activities.

See before-and-after eyelid lift surgery pictures on our website.

To schedule a consultation for eyelid lift surgery in Santa Barbara by Dr. Perkins call (805-563-0000).

Liposuction, Vanquish, and CoolSculpting in Santa Barbara

Over more than three decades of my cosmetic surgery practice, I have found Spring and Summer to be a popular time for people to “renew” their appearance. In preparation for beach gatherings and pool parties, body contouring is often addressed. While liposuction is undoubtedly the most reliable and quickest way to improve contour issues on any part of the body, patients are hearing/seeing advertising about non-invasive fat reduction and I thought I would use this blog post to discuss the pros and cons of liposuction versus non-invasive techniques currently available.

Liposuction is a surgical procedure that is now most frequently done using oral and intravenous sedation plus local anesthesia (so patients don’t have any added risk with general anesthesia). The procedure permanently removes excess fat from beneath the skin to improve “problem” areas and if you have excess skin this can often be removed at the same time. Liposuction incisions are small (less than 1/4 inch) and placed in “hidden” locations. Pain is usually minor – often controlled with ibuprofen or Tylenol – and light activity can be resumed a few days after the procedure.

Non-invasive fat reduction has been around for a few years now and we know that it can work. For patients who do not want or cannot have surgery, several devices are currently available and others are on the horizon. Two technologies currently available are CoolSculpting (freezes fat cells) and Vanquish (heats fat cells). Both devices cause cell injury that leads to eventual death and elimination resulting in less fat volume. Non-invasive methods involve a series of treatments and the results are not as predictable or dramatic as liposuction but there is usually some noticeable contour improvement.

CoolSculpting (or cryolipolysis) uses a vacuum-like applicator with cooling plates that cools skin and destroys fat cells by freezing some of them. The frozen cells die and are “cleaned up” over the next 2 to 3 months. An “optimum” result is about a 20% reduction, so several treatments are usually needed to obtain the contouring goal.

Vanquish is a selective radio freqency treatment that targets the deeper subcutaneous fat and heats the cells to cause destruction. As with cryolipolysis, the cells are “cleaned up” over the next few weeks. Treatment time is much faster than with CoolSculpting. The percentage reduction is variable but at least 20% is common. A series of treatments is recommended. A side-effect “bonus” with radio frequency is that some degree of skin tightening is also seen.

The answer depends on the amount of improvement you are looking to achieve. If you want a more dramatic change, have a larger amount of fat, or want to do just 1 treatment and be done, then liposuction is probably the better choice. Those needing only small changes, or who cannot take any time off and don’t mind doing a series of treatments to achieve an end result, may do well with non-invasive options.


If you would like to discuss your concerns, contact my office (Cosmetic Surgery Center in Santa Barbara) to make a consultation appointment (805-563-0000). I look forward to bringing out the best in your appearance now or any other time of the year.

Rhinoplasty Nose Job Surgery in Santa Barbara

Last year Rhinoplasty ranked #2 in the list of Top 5 Cosmetic Surgery Procedures of 2014 (breast augmentation was #1). Changing the breathing function (correcting a deviated septum) or trauma from an injury can be reasons for rhinoplasty but the majority of people who have a “nose job” – as it is commonly referred to – are doing it to change the aesthetic appearance of their nose. Bumps, humps, wide nostrils, a droopy or bulbous tip, or asymmetry are among the reasons that my patients have elected to have nasal surgery.

Patient of Dr. Terry J. Perkins, Rhinoplasty Before & After

When I perform rhinoplasty in Santa Barbara, I find that it is very important to consider the nose in relation to the rest of the facial features. My goal is to create a balanced profile that looks natural. An overcorrected nose can draw just as much (unwanted) attention as a nose that is too big for a person’s face. Nasal surgery can be performed on a younger person but I recommend that the person wait until their late teens as that is when the nose has likely finished its growing phase and the surgical result can be more predictable.

The majority of nasal surgeries done at Cosmetic Surgery Center in Santa Barbara are with a closed technique that allow incisions to be hidden inside the nose. We use a combination of local anesthesia, oral and intravenous sedation to keep the patient comfortable and unaware. General anesthesia is not needed. Most patients experience minimal pain and some stuffiness (similar to a mild cold) for about a week after surgery and return to work 7 to 10 days after the surgery.

A temporary option for smaller corrections to the nose can be done with injectable dermal fillers (such as Perlane or Restylane). Fillers can be used to smooth out irregularities and/or fix asymmetry issues on the bridge or the sides of the nose but not the tip. If there is an issue with the tip, it is much better addressed surgically. Using fillers can give a person an idea of how their nose would look if they wanted permanent correction through surgery. Dermal fillers can last 6 months or more and the results are instantaneous.

Schedule a consultation for rhinoplasty in Santa Barbara by calling my office at (805) 563-0000. 

Abdominal Liposuction and Tummy Tuck in Santa Barbara

Bulges and excess skin in the abdominal area can be hard to reduce, especially for those who have lost a large amount of weight or for women who have had children. It can be especially discouraging for those who watch what they eat and exercise consistently but can’t get rid of their “pouch” or love handles. Luckily, there are several cosmetic surgery options, depending upon a person’s concerns and end goal.

Abdominal Liposuction
If there is not a lot of excess skin, liposuction in Santa Barbara is a great option. Small incisions are used to insert a small tube (called a cannula) into the skin to remove and contour fat beneath the skin. It should be noted that fatty tissue is soft and not attached as firmly to the skin, muscle, nerves, and blood vessels so it can be selectively removed without injuring other tissues. Abdominal Liposuction will nicely shape an area. Liposuction is a body contouring procedure, not a weight loss procedure.
Tummy Tuck (Abdominal Liposuction with Skin Excision)
If there is a lot of excess skin then skin excision may be recommended for the best result. This procedure is called abdominoplasty and is commonly referred to as a “Tummy Tuck“. A standard Tummy Tuck involves the full abdomen. The procedure includes detachment and repositioning of the belly button and tightening the abdominal muscle. Excess skin is removed. The incision is longer than a C-section but can be hidden by a swim suit or underwear. There is also a less involved procedure referred to as a “Mini” Tummy Tuck. This addresses the lower abdomen only, below the belly button. The incision is similar to a C-section incision in length and placement. 
For all of these procedures, there is no need for general anesthesia. A combination of local anesthesia, oral and intravenous sedation provides comfort and amnesia throughout the procedure and patients are pleased to not have the “hangover” of general anesthesia. 
Interested in abdominal liposuction or a tummy tuck in Santa Barbara? Contact my Cosmetic Surgery Center Santa Barbara practice at 805-563-0000 to schedule a consultation.

Neck Lift Cosmetic Surgery in Santa Barbara

Neck Lift cosmetic surgery in Santa Barbara is most commonly known for getting rid of the double chin or the “wobble” in the neck area but you would be surprised at how much it can truly change an appearance. Before we discuss the results, let’s look at why Neck Lift surgery may be needed in the first place.

Aging Neck 
Neck skin is delicate – more so than facial skin – and is exposed to the same elements as the face but often times it is neglected. I always like to remind people that their skin care routine should not stop at the jawline. I recommend cleansing, moisturizing, and (most importantly) using sun screen on the neck area. Due to the delicate skin (and possibly lack of sunscreen in that area), the neck may age prematurely causing the skin to become loose and crepe-y. The “double chin” may be due to a number of causes including genetics, weight gain, weight loss after weight gain, loss of muscle tone, and, of course, aging.

Neck Lift Surgery
The patients I see at Cosmetic Surgery Center in Santa Barbara are interested in Neck Lift surgery because they feel that their neck looks “old”. We can restore their neckline to what it once was by tying muscles to create a “sling effect” for better support and adding a suspension suture to give more long-lasting support to the neck. Incisions are hidden behind the ears and a small one under the chin.

Results of Neck Lift Surgery
Neck Lift surgery can get rid of the double chin and re-contour the face. With the “heaviness” gone from the neck and jawline, many of my patients report that their updated appearance not only makes them look younger but also makes them look like they have lost weight!

Santa Barbara Neck Lift Surgery Patient of Dr. Terry J. Perkins

I perform cosmetic surgeries that give a natural, rested, “non-operated” look. If you are interested in Neck Lift surgery in Santa Barbara call my office – Cosmetic Surgery Center – at 805-563-0000 to schedule a consultation appointment.

Cosmetic Plastic Surgery Trends in 2014

The statistics for cosmetic surgery trends in 2014 have been published by The American Society of Plastic Surgeons. It is always interesting to see what the most popular procedures are!

The top 5 cosmetic surgery procedures in 2014 were:

A few other procedures that are worth noting (as we do them in our Santa Barbara cosmetic surgery office) are:
If you are interested in having cosmetic surgery in Santa Barbara, call 805-563-0000 to set up an appointment with Santa Barbara cosmetic surgeon Dr. Terry J. Perkins.