Ask Doctor Jeff Hall

Ultherapy-Skin Tightening That Works

teamhall — Wed, 15 Jun 2011 20:03:13 +0000

I am back from my blogging hiatus. I am excited to announce the addition of a new modality to our practice called Ultherapy^® . It is something that caught my attention in the fall last year. We have always been interested in something that will tighten the face without surgery. However, the issue is does it work effectively and is it safe? Up until now the technologies have been very inconsistent and sometimes very painful. Also, much of the marketing by the companies selling them is hype vs. reality. From my standpoint I want to see the science behind the technology and judge the results based on input from my respected unbiased colleagues who are experts in the field. Ultherapy^® has delivered, and my colleagues have given it their endorsement. We brought the ultrasound technology in a few weeks ago and have treated a number of patients. Their results have been amazing across the board. It is tightening their neck and face along with elevating their brows – all without surgery! There is no downtime or recovery with the procedure. The results peak at three to six months and should last over two years. Physicians in Europe are seeing results last three to five years. The ultrasound based technology targets the energy in the dermis and the muscle layers with a focused thermal injury that stimulates new collagen production/tightening. Other technologies have not been able to do this and as a result have had less effect or success. I was so impressed with it that I personally had a treatment at our Ultherapy^® event. There is some discomfort with it that can vary with each person. We typically perform nerve blocks and offer oral sedatives to our patients. They have tolerated the treatments very well. This technology is another piece of the puzzle and allows more choice to tailor the right treatment for our patients both surgical and non-surgical.

Ultherapy Before

Ultherapy After

ZELTIQ™ vs. ZERONA™

teamhall — Wed, 25 Aug 2010 15:41:00 +0000

The battle has begun over how best to reduce fat without invasive surgery. I have been patiently and curiously waiting to see where technology would send us in this endeavor. For years we have had surgical options to contour the body, usually with liposuction to reduce the fat layer-fullness. However, not everyone is excited about surgery: the cost, the risk and the down time. So offering a procedure that is non-invasive, low risk and has minimal downtime, is somethign I have eagerly anticipated adding to my practice. There have been procedures that have claimed to work, but the results up until now have been disappointing. Recently, there has been a great deal of press about external laser fat reduction using ZERONA™. It essentially reduces volume by shrinking the size of the fat cell. It is relatively painless and requires a series of treatments. There is no down time, but it can be expensive since the results are only temporary. As a result, I have not jumped on the bandwagon for this procedure. Also, physicans using this procedure typically rent out a machine on an as-needed basis, limiting their ability to control quality. I have tried to stay abreast of emerging technologies and recently read an article about ZELTIQ™ in which I recognized one of the quoted physicians who had used the machine with encouraging results. Next, I did my own research and found out that the technology made sense and the results were predictable. Simply put, the machine causes a cold thermal injury to the fat cell called cryolipolysis that destroys the fat cell permanently without damaging the surrounding tissue. Areas that have been successfully treated include the abdomen, flanks, back and thighs. The treatment is painless without downtime or recovery with the area treated losing 25-40 percent of volume. The volume loss occurs over a two to four month period as the body absorbs the destroyed fat cells. It is ideal for people that are unable to lose volume in these difficult areas that we previously could only offer liposuction. ZELTIQ™, from my standpoint, has won the battle. Approximately two months ago I had a treatment done on my abdomen and have been impressed with the results. You can see the video of my procedure here:

If you are interested in seeing if ZELTIQ™ is right for you, please come in for a free consultation. Visit our website for more information.

Patient Beware

teamhall — Mon, 17 May 2010 03:30:54 +0000

Recently, I have seen and heard about cosmetic surgery being done by physicians that are performing the procedures in their offices in the local area that I do not know. Definitely there are going to be new surgeons moving to Austin to practice and older ones retiring. However, after investigating these new practices they are not what they seem. They are offering deals that seem great to the consumer but do we know their credentials. Some of the practices are using physicians that do not live here and are flying them in to do the services-itinerant type surgery. Who is responsible if the patient has a complication if they have flown away in an airplane? Where does the patient go if there is a problem? What are their qualifications to perform the surgery and what is the safety of their facility? Does the facility have certification to the appropriate level? I respect the fact that there is some overlap of surgical specialities to perform certain procedures. However, when physicians have no formal surgical training it is placing the patient at risk. Why do you think there are formal residency training programs and board certification that take many years to complete? One might be able to learn a technique going to a weekend course but clinical judgment is not learned overnight. Unfortunately, profit can take a backseat to safety. Cosmetic medicine is becoming more and more competitive and lucrative to the provider. Insurance reimbursement continues to decline and physicians are looking to cosmetic medicine since it is done on a cash basis prior to surgery. Also, technology companies are complicit in the problem as well. They are providing equipment and surgical material to these physicians with little oversight on their training. Their bottom line is to make a profit and sell their product. I have seen the consequences from patients having had surgery or treatments done by some of these businesses. Some patients have paid significant amounts of money without results or they have had complications that are not easily corrected. The bottom line is that no one is monitoring surgery that is done in the office and there are no penalties to the physicians. There is some oversight by the American Society of Plastic Surgeons in that if you are a member you sign an affidavit each year concerning what level of anesthesia is done in your office and that you have the appropriate level credentialing for surgery.

Facelifts-Are they all the same?

teamhall — Wed, 03 Mar 2010 22:36:23 +0000

Facelifts are definitely not all the same. Over the years the techniques have evolved for facelifts and there are many forms that are currently being marketed. What is confusing is do you need one and which one is best for you. There are some basic principles that we have learned in rejuvenating the face including how we analyze the anatomy. In the beginning we tended to focus on the skin and did procedures that only addressed this problem of sagging skin and wrinkles. However, our results tended to look unnatural and to not last very long. The pendulum swung the other direction and more invasive deeper procedures were developed. The results were better but the cost and recovery was more intense. Now, more and more physicians are trying to get into the game-the cosmetic business. They tend to market their procedures as minimally invasive and little down time. That may be the case and may work well in some-usually the person that needs the least. Otherwise, the results tend to look unnatural and not last very long. From my standpoint the facelift should be only part of the picture in rejuvenating the face. One needs to address the whole area-brow, eyes, midface, and neck-and make a individual plan for each person. We cannot assume that the face changes the same in all areas at the same rate. So, fit the procedure to the needed changes and not to a gimmick or how inexpensive it is.

Read the Label-Food, Inc.

teamhall — Fri, 12 Feb 2010 23:04:36 +0000

Recently, a movie came out that is called Food, Inc. My wife and I were looking for a movie to watch on Apple TV and she said that she had heard of it. She was interested in watching it since it was about the food industry and your health. We made a New Year’s resolution to be better with our health and diet. So, we rented the movie and it was very eye opening. We both knew that the food that we eat has additives quite often and that we should be better in eating organic foods. The problem is going 100% organic means paying more for the food and finding it is more difficult. The movie shows how the food gets from its origin to the table. Basically, the food industry is now controlled by a limited number of people and profit is the bottom line not your health. Watch the movie and you will understand the process how our food is manipulated, processed, and altered. Now, my wife and I realize that the added cost and the difficulty of getting organic to be worth it to ensure the best for our families health. The movie confirmed that what we did in the past by giving our children only foods that organic and have no additives since birth was the right choice.

How about those lips?

teamhall — Mon, 30 Nov 2009 19:02:24 +0000

Before Lip Implant

After Lip Implant

Tired of looking in the mirror and feeling that your lips are getting smaller? Have you tried to improve them with injectable fillers? Fillers work but they are only temporary and can be expensive over the long run. Fat can be injected but usually requires an invasive procedure to harvest the fat and more anesthesia. The solution is a lip implant called Perma™ facial implant made by SurgSil™. It is a soft silicone implant that can give you the improvement you want and be long term. The procedure to insert the implants is easily done in the office using local anesthesia. The recovery is very short and most people will be healed within a couple of weeks. The older type implants were sometimes to firm and did not have a tapered contour making them unnatural. This implant is both soft and has the appropriate contour. Because of this improvement I have used the implant with excellent results. Also, the sizing is adjustable and different sizes can be used in the upper and lower lips. See more results on our website…

Zyto is Here

teamhall — Wed, 18 Nov 2009 20:32:44 +0000

Zyto Hand Cradle

How does one know what supplements to take or what could be making you feel less than perfect? We have partnered with Peoples Pharmacy to bring in a new technology to help answer these questions called Zyto Bio Feedback. They have been using it with very positive results. The Zyto Bio Feedback machine is a unique tool for locating deficiencies in the body and determining which specific dietary, lifestyle, and supplemental changes will have the most lasting impact on bringing the body into homeostasis.The Zyto machine monitors the Galvanic Skin Response (GSR) of the body, interprets it, and decodes it into the computer system. This virtual conversation with the body allows the machine to precisely determine what deficiencies are present and what specific changes will work to return balance to the body. We are going to integrate this information to maximize our patient’s health for the best surgical experience and recovery. Also, we are offering it as a way of achieving the wellness program that meets your specific needs.

What Can I Do?

teamhall — Mon, 16 Nov 2009 21:01:30 +0000

Turk Pipkin's Nobelity Project

With the holidays coming upon us quickly the atmosphere of giving increases. This is a special time and most of us have fond memories of our childhood when we got a special gift from Santa. Unfortunately, if we look at the world as a whole this type of experience is the exception rather than the rule. My wife and I are very blessed and realize that we cannot take this for granted. One of the ways we can show this is by giving or helping the less fortunate. We understand that the simple things like food, water and clothing can be luxuries in other countries as well as our own. Also, these needs are not just during the holidays but are year round. Both of us have traveled to parts of the world and have seen people in need. It gives you a different perspective that is hard to express in words. You are able to board a plane and leave the suffering behind, but the suffering still remains. I can remember there being charity groups for places like Africa since I was a child. One may ask why haven’t things changed and why do they still need help? Where is our money going and shouldn’t we help the needy here first? Yes, some of our charity has been wasted by corrupt people in power and the poor have not been help. However, times are a changing and our giving is now making a difference. Organizations like the ONE organization and DATA have shown us that it can. Locally, the Nobelity Project with Turk Pipkin and the A Glimmer Of Hope foundation with Philip Berber are changing lives in Africa with their work. Being a fan of U2 I have seen Bono make this cause his passion. He is not in it for the glory. We have seen him speak on two separate occasions. He made the point that the most needy person in the United States is so much better off than the same person in Africa. Whether a person lives or dies can be determined by where a person is born in Africa. Hardly the case in the US or in developed countries. So, lets empower one another to give not just during the holidays but year round to change another’s life. I know I can. Can YOU?

Turkey Time

teamhall — Mon, 16 Nov 2009 20:45:35 +0000

Its almost here and time to get ready for the feast. We are trying to decide what to cook for the special day. I have fried a turkey in the past and it has been very moist and tasty. Sometimes something new for a traditional day is not received well by all. What do you do? Well, how about cook two turkeys? This year we are going to have a small crowd and cooking two birds would be too much. I might have to flip a coin. We have friends that have a ranch in Dripping Springs and they are so nice to have invited our family to stay there during the holiday. Last year, I was trying to shot a deer but wound up shooting a turkey. The triplets want Mommy and Daddy to shot both. We wish everyone a safe holiday and Go Horns.

Feel Better as Well…..

teamhall — Wed, 04 Nov 2009 16:01:53 +0000

Plastic Surgery may go along way to make you look better but it is only part of the picture. Quite often we can reach our goals with surgery to rejuvenate our body. However, it is important to consider how you feel on the inside and how you maintain results for the long run. This is where wellness comes into play. Taking a daily vitamin and some limited exercise only scratches the surface. It is like having to put together a puzzle without all the pieces. We are individuals and what our body needs varies. At Hall Plastic Surgery/Rejuvenation Center we take this into consideration and can determine your specific needs. This way we can tailor a program that will make you feel better and maintain your wellness after surgery.