What is carpal tunnel syndrome and how is it treated?

carpal tunnel

As a plastic surgeon, I have the opportunity to operate on several areas of the body.  Our hands are vital to our everyday life and I enjoy being able to restore their function by performing carpal tunnel and trigger finger surgeries.   The carpal tunnel is a space in the wrist that various tendons and the median nerve pass through in order to reach the hand. The median nerve has several functions, including providing sensation or feeling to the thumb, index, middle, and half of the ring finger as well as providing supply to the muscles at the base of the thumb. Sometimes swelling can occur in this space, which compresses the nerve and can cause symptoms of numbness and weakness in the hand. These symptoms can be permanent if not treated early.  

There are various treatments for carpal tunnel syndrome depending on your symptoms and their duration. The simplest treatment is to wear nighttime splints to help prevent compression on the nerve.  Another potential treatment option is a steroid injection into the carpal tunnel. Lastly, a surgical procedure called a carpal tunnel release, could be considered. 

The surgery takes approximately 15 minutes and is performed as outpatient. The surgery involves making an incision approximately 3 cm long in the palm near the wrist and dividing the ligament of the carpal tunnel, which relieves the pressure on the nerve. You are typically able to use your hand for light activities (such as typing) in a few days and will have near full use of your hand after four weeks. .   As a plastic surgeon I have training in advanced reconstructive techniques, including hand surgery, and focus on suturing techniques that minimize scarring.

This surgery is usually covered by most insurance companies.  Call me today to schedule your consultation at our office located in Troy, Michigan.  248-524-0620. 

Dr. Sarah Elswick 

Plastic, Reconstructive and Aesthetic Surgery

Will aesthetic filler permanently stretch the skin on my face?

 

Dermal fillers are used to correct fine lines, wrinkles and add volume that has been lost due to the aging process.  Aesthetic injections replace lost volume, hence filling an empty space.

 

When injecting for wrinkle correction the product is filling the area under the skin to lift it up to be the same level of the surrounding skin. This type of injection is not going to noticeably stretch the skin. We also will add product to increase volume. The most common area for this is the cheeks where we naturally lose collagen over the years.  This type of injection is essentially stretching the skin as the volume is added but it is in a minuscule manner. To keep this in perspective most patients are not injecting extensive amounts of product. A 1 ml syringe is about 1/5 of a teaspoon. Dermal fillers are temporary, typically lasting anywhere from 6 to 18 months, depending on the product.  As the filler slowly dissipates most skin is able to contract to its original presentation.

 

Many of the questions I receive like this are due to not fully understanding the product/procedure. Before I start any treatment I take the time to ensure my patient’s questions have been answered and they understand.    Patient education is one of our top priorities. We offer complimentary consultations on all of our aesthetic injections. Call today to schedule your appointment 248-524-0620. 

 

Raquel Merlini, RN

Aesthetician and Registered Nurse

Aesthetic injections can leave a bruise, learn steps to minimize

Whenever you are using a needle to inject there is a possibility of bruising. There are several vessels under the skin that can be damaged during injection. This is normal and can result in bleeding and eventually a bruise. The risk of bruising is greater with derma filler injections such as Restylane® or Juvederm®. This is due to the use of larger caliber needles because of the consistency of the product. Typically fillers are injected deeper into the tissues which also increases the likelihood of getting into a vessel that cannot be seen from the surface. Most side effects are mild to moderate and resolve in under 7 days. The most common side effects that are reported are mild pain/tenderness, bruising, redness, lumps/bumps, discoloration and itching at injections sites.

There is no way to predict whether or not you will bruise or guarantee no bruising. However, we do have some steps that can be taken to help reduce the risk of bruising.

Stop taking any over the counter medications or supplements that thin the blood 1 week before such as:
Aspirin, NSAIDS, Vitamin E, Fish Oil, Garlic, Ginger, Ginko Biloba, Ginseng and Green tea.
Check your prescription medications that thin blood such as:
Coumadin and Plavix. Never stop taking these medications without prior approval from the prescribing physician.
No alcohol consumption 24 hours prior to injections.
Icing the area immediately prior to and immediately following can constrict blood vessels to reduce pain, swelling and bruising.
Avoid exercise for 24 to 48 hours after injection. Physical activity increases your heart rate, blood pressure and blood flow. Minimal blood flow allows time for the damaged vessels to repair faster.

Patient education is one of our top priorities. We want to ensure you fully understand our services and feel confident in our quality of care. Call us today to schedule your free consultation. 248-524-0620.

Kristen Lotz, PA-C

Are Botox Parties Safe?

Posted May 29th, 2019 by Social Media and filed in Botox, Plastic Surgeon Troy MI

Botox is a pharmacological injectable agent that is regulated by the FDA and is only allowed to be administered by a medical professional such as a Doctor, Physician Assistant or a Registered Nurse under the direction of a physician (varies by state).  In order to be certified to inject Botox, professionals must complete training that includes both clinical and hands-on courses. Aestheticians cannot be certified to inject Botox.

 

Injecting Botox for wrinkles may only be cosmetic, and it is relatively safe, however it is still a medical procedure.  Therefore is safest when performed in a medical setting. Complications can occur when the injections are not administered properly.  Your injector should review your medical history and have knowledge of any allergies. A qualified injector will thoroughly discuss the risks and possible side effects and have you sign a consent form that states you understand and accept the risks.  

 

If you are attending a “Botox Party” outside of a medical facility, ask yourself why is this person offering it in this way?  Is it purely for marketing or social reasons? You may be paying less but is it worth it? If a problem should arise, are you going to receive the proper aftercare?  Is your injector or someone in their medical practice available 24/7 for any concerns or issues?

 

In my opinion, it is always “better to be safe than sorry”, especially when it is something concerning your body, health and well-being.  It’s best to choose a reputable, experienced medical professional who has been certified to inject Botox and has a medical office in which they practice.  

 

We offer complimentary consultations to ensure you understand the treatment and determine if it is the right treatment to address your area of concern.  Call us today at 248-524-0620 and feel confident that patient education and safety is one of our top priorities.

 

Kristen Lotz, PA-C

Beauty Sleep, not a myth!

We have all heard the saying “Time to get your Beauty Sleep”.  Although many think it is just an old Wives’ tale, the truth is the amount of sleep you get at night is a critical component of your body and skins health. As a board certified doctor, I like to look at the complete health of my patients to help them achieve their aesthetic goals.   Proper sleep means an increase in growth hormones which allows cells to repair. Without proper sleep the broken down cells accumulate which causes more noticeable signs of aging.

 

It has been shown that not getting enough sleep can increase levels of the stress hormone, cortisol. Increased levels of cortisol causes more inflammation in the body. More inflammation in the skin can cause the breakdown of collagen and hyaluronic acid which are what give skin its elasticity and glow!

Decreased sleep equals decreases moisture levels and lowers pH levels in the skin as well. When your pH levels drop it creates an imbalance in your skin and leaves skin looking dry, uneven, red and can even trigger breakouts. If you have dark circles your lack of sleep could be the cause. Lack of sleep is the number one reason your blood vessels dilate which leads to the appearance of dark circles under the eyes!

 

Therefore, the wives tale is actually a wise recommendation! Starting today in celebration of National Sleep Day “Get your Beauty Sleep” and you will feel and look more refreshed all day!!

 

Dr. Clarissa Kroese

Radiesse, an Alternative filler with natural looking results.

The exciting world of aesthetic injections is constantly growing and improving. This gives you options to be able to choose the product that you are most comfortable with and strive for the desired results.  

 

Are you feeling like your face is “falling” or maybe you’re just feeling like you need a little lift?! We have a variety of options to help you! We have several gel hyaluronic acid fillers such as the Juvederm and Restylane product lines.  These are great options to for those seeking immediate volume to the face. We also offer Sculptra which is a poly-L-lactic acid based treatment. This product works to stimulate the body’s own collagen production. Sculptra typically takes about 6-8 weeks to see results of the collagen building. This is perfect for the person looking for slower more natural improvement.   If you like the idea of a filler that promotes collagen growth but also want immediate volume we offer Radiesse.

 

How does Radiesse work? Radiesse works right away adding facial volume and diminishing the appearance of facial line and wrinkles.  Wrinkles form due to the natural loss of fat/volume and decreased levels of collagen over time. Radiesse is a smooth gel filled with tiny calcium hydroxylapatite microspheres. This gel, when it is injected, immediately lifts and adds volume to the face. Over the next few weeks these calcium hydroxylapatite microspheres stimulate the body to produce collagen. Your new collagen will surround the microspheres and eventually the microspheres and the gel are naturally metabolized by your body.  What you have left is newly formed natural collagen. Because of this, Radiesse produces a nice natural result. You will see a restored, lifted, more youthful appearance without looking overdone.

 

Typically areas of use for Radiesse are nasolabial folds, marionette lines, cheeks, down turning corners of the mouth, chin wrinkles, jowls and hands. Results have been shown to last a year or more in many patients. Radiesse is mixed with lidocaine to help make the injecting experience more comfortable. Like all fillers there is a risk of bruising, swelling, mild irritation, itching, redness or tenderness at the injection site. All of these reactions will typically resolve on their own.

 

We offer free consultations!! Call our office, located in Troy, MI, today to schedule yours! 248-524-0620 I will answer all your questions and together we will develop a treatment plan that works best for you! The world of aesthetic injections has lots of options and I would love the opportunity to work with you!

 

Clarissa Kroese, DO

Aesthetic Medicine

 

 

After care matters! Learn how vitamin intake can help with hair loss.

Is your hair thinning?  Do you wish there was something that could increase the density of your hair?  Well, now there is! Platelet Rich Plasma (PRP) is now being used to promote hair growth in areas where the hair is thinning. Human blood contains stem cells and other growth factors that help in tissue healing and regeneration. Our procedure Platelet Rich Fibrin Matrix (PFRM) is an advancement in PRP and extends the activation time for maximum results.  It is a non-surgical procedure that utilizes your own blood to stimulate the hair follicle, increase hair growth and increased density.

 

After treatment/care is always an important step in aesthetic medicine.  You should always ensure you understand the post procedure process to provide for the best aesthetic outcome.  For this treatment, it has been found that taking a supplement can complement the PRFM procedure. The vitamin supplement is called Vivsiscal® Professional.  These supplements nourish hair follicles from within, strengthen and promote the growth of existing hair, and promote the growth of hair that has slowed or stopped growing.  Using these supplements will leave the hair stronger, healthier and more vibrant. The Viviscal Professional supplements contain the exclusive and clinically proven marine complex AminoMar® which is derived from key marine sources that promote hair growth and thickness.  It also contains Biotin, Vitamin C, Apple Extract and L-Cystine and L-Methionine. All these are ingredients aid in increasing hair density, diameter and growth. A study by Viviscal Professionals showed that 92% of women noticed an increase in their hair thickness by using these vitamins.

 

 

 

I like to look at all aspects of our procedures to achieve the best results for my patients. If you suffer from thinning hair then PRFM with Viviscal might be for you! Call and schedule your complimentary consultation and we can talk through all your options!  248-524-0620

 

Dr. Clarissa Kroese

 

 

 

The order in which you receive Aesthetic treatments is important

Botox before facials? Facials before lasers? In the world of aesthetics there are many types of treatments that range from noninvasive facials, aesthetic injections to comprehensive skin resurfacing lasers.  It’s important to receive these in the proper order to ensure the best aesthetic outcome.

Let’s start off with facials.  It is always best to receive your facial before any aesthetic injections. A facial involves massaging and rubbing of the face which can move the product to an area it was not intended for. Vigorous skin treatments such as microdermabrasion and microneedling could also cause the product to spread. If a neurotoxin, like Botox, disperses to a nearby muscle a side effect is droopy skin. This is commonly seen in the eyelid/brow area.  Therefore as a precautionary measure it is best to get the facial/vigorous treatment first or wait at least 2 weeks after receiving injections.

Lasers and treatments that are heat based are ideal before aesthetic injections. Most dermal fillers are made up of hyaluronic gel, which attract water and expand. Lasers that use heat may diminish the water content in the skin and the product, depending on the depth of the injection. Neurotoxin like Botox and Dysport are used to address wrinkles associated with facial animation. Heat causing treatments may cause swelling which could possibly diffuse the product to other areas. This means it is best to receive the laser treatment before any aesthetic injections.

 

The leading way to maintain a youthful face is to collaborate between non-surgical cosmetic procedures and the aesthetic treatment room. Knowledge is power and it is beneficial to know what sequence procedures are best performed in. This is something your Injector and Aesthetician can advise you on during a Skin Assessment/Skin Care Consultation. Our highly qualified team who will work with you to determine the best treatment plan for you. Call today to schedule your complimentary consultation. 248-524-0620.

Raquel Merlini, RN

 

 




Save money on Aesthetic Injections

How can I save money on Aesthetic Injections? 

Everyone likes to receive something for less and aesthetic injections are no exception.  The good news is the two major pharmaceutical companies, Allergan and Galderma recognize this and want to reward you for using their products.  Both companies have point reward programs that give you money off your next injection. I know what you are thinking, another reward system to keep track of and we sometimes forget to check if we have points. No worries, we will manage it for you and ensure that you receive your discount! We will also notify you in advance if you have points expiring.

  

Enrolling in these programs will definitely save you money. During the month of October, Galderma is donating $25 to the National Breast Cancer Foundation for every NEW consumer member who joins. Save money for yourself and help save a life. It doesn’t get any better than that!

 

Call today to schedule your next appointment and let us help get you enrolled! 248-524-0620  

 

Liposuction for Fat Stem Cells

Liposuction has more benefits than losing a few inches…. Learn how storing your fat stem cells may help fight future disease.

For years the term “stem cell” has been used in the medical profession, seen in the news, and lately, it is showing up in our social media feeds. So what is a stem cell anyway? A stem cell is a type of cell than can become many other cell types, they support your immune system, coordinate healing and build healthy tissue. The medical possibilities they offer is vast. Currently there are over 700 clinical trials using these cells to treat age related disease and even aging itself.

But there is a problem. As you age you lose these cells and the ones that remain become damaged and less effective. At our practice, we solve this problem by storing your stem cells for you NOW in their youngest and best possible state. By storing your stem cells today, you are stopping the clock on a very important component of your biology. In fact, Dr. Schenden recently banked his own cells.

In the aesthetic world liposuction has been performed for years to contour the body and remove unwanted fat. This fat is then discarded. What many people don’t realize is that there are copious amounts of stem cells in fat. The benefits of liposuction can be more than losing a few unwanted inches. These cells can be processed and reintroduced into the body as a natural filler to plump certain areas with the Fat Grafting technique and Dr. Schenden can collect this fat and isolate the stem cells for cryopreservation. Storing these cells is simple and could be the greatest decision you make for your future health.


Dr. Schenden performs both Bone Marrow and Liposuction Fat Stem Cell Aspiration for storage. Call our office located in Troy, Michigan today to set up your consultation 248-524-0620 or contact our partner company Forever Labs at foreverlabs.com for more information on stem cell storage.