The Role of Beauty in Our Day to Day

As we enter 2014 it is my pleasure to wish all my patients a Happy New Year and best wishes for a peaceful and prosperous 2014.

Each New Year brings the possibility of life changes large and small – some we can control and some we cannot. I have always viewed my role as a physician-surgeon as that of helping my patients achieve their best aesthetic and functional outcomes. Most times this results in a small life change; sometimes the change is profound.

In the past I have discussed the “Neuroscience of Beauty” – the primal reason why we want to be attractive. In the Globe and Mail Saturday January 11, 2014, Leah Eichler, in her excellent column Women at Work, gives a more objective assessment of the “Beauty Premium” both in the workplace and life in general. In a nutshell, society rightly or wrongly places a premium on and rewards beauty. To quote Ms. Eichler “beauty pays off” and a “beauty premium” exists in the workplace. Ms. Eichler emphasizes that the total package – hairstyling, fashion sense and intellectual value- is of paramount importance to achieve success in life and the workplace. However, enhancing your basic attractiveness with cosmetic dentistry, a new hairstyle or tweaking those wrinkles and frown lines with Botox, Juvederm or perhaps a forehead lift may also be beneficial. The good news is that while it may be difficult to get a job promotion, it’s relatively easy to erase forehead wrinkles with Botox or plump up those thin lips with Volbella.

On that note, I am pleased to be attending “Rejuvenation of the Aging Face” a four day, world class Masters of Facial Rejuvenation program in San Diego. This annual event sponsored by the American Academy of Facial Plastic and Reconstructive Surgery will highlight new advances in the surgical and non-surgical treatment of facial cosmetic concerns. As always I am sure I will benefit from the expertise of the wide range of international speakers present.

Be sure to stay warm and safe – remember spring is only two months away.

Dr. Keohane

Natural Fuller Lips

I trust you have had a great, sun and fun-filled spring and summer. Fall is definitely upon us – funny how that happens every year.

I was able to attend a couple of great conferences this year on rhinoplasty and facial cosmetic surgery in Chicago and Banff.  I also presented a paper on “Complex Reconstruction Rhinoplasties Utilizing Ear Cartilage and PDS Sheeting,” an exciting breakthrough in revision rhinoplasties. To date, I believe I have one of the largest series of this type of surgeries in Canada and perhaps North America.

I also attended my thirtieth medical school reunion.  That officially makes me either an old or experienced physician – you can decide which. It was wonderful to see my classmates and realize how lucky we have been, in both life and career pathways. Enough about the “old stuff," here is something new.

Allergan has released a new dermal filler called, Volbella – a cousin to Juvederm Ultra Plus and Voluma. It is specifically indicated for lip augmentation and will help to diminish vertical lip lines (often called “smoker lines”) and naturally accentuate the vermillion border and Cupid ’s bow. If you have always wanted to have you lips enhanced with filler, but were afraid of over-filled, artificial appearing lips, then this could be the product for you to try. It is an exceptional product that is easy to use with long lasting results. Initial patient feedback has been very positive and it will probably become the product of choice for lip augmentation.

Every year as we move towards the holiday season, Botox and Juvederm appointments become oversubscribed. We never want to turn anyone away and do our best to accommodate everyone’s schedules. If you are planning a “touch up” with Botox, Juvederm, or both, the earlier you book your appointment, the more likely we are able to facilitate your appointment request.

The same thought process applies to surgical procedures – each year we add additional surgical days in our Non Hospital Surgical Facility suite to accommodate the seasonal rushes. However, the more lead time we get the better.

Have a great fall and Halloweeen. Remember that winter is just around the corner.

Dr. Keohane

Spring Sunshine and Your Skin

As I compose this latest newsletter, I can’t help but notice the 10cm of fresh snow that we have just received. Spring certainly seems a long way off. With the eternal optimism that defines Albertans, I am confident that we will soon be enjoying Alberta’s long sunshine-filled days as we pursue our favorite outdoor activities.

Albertans annually receive some of the most hours of sunshine in the entire world, despite our snowy winters. While this is great for honing our cycling or golfing skills, it also puts us at risk of developing skin cancers, such as basal or squamous cell carcinoma as well as malignant melanoma.

While my practice is not focused on skin cancers, every year I detect several early facial skin cancers, including melanomas on patients that come to see me for other problems. Fortunately, most facial skin cancers are slow growing and when detected and treated early, cure rates most favorable.

These skin cancers are caused by solar (sun) radiation and many factors increase our chances of developing skin cancers. These include occupation, genetics, skin type, pigmentation, time of day exposure and believe it or not, elevation. In general, someone such as myself, a Fitzpatrick type I skin – very white with little pigment, always burns - is at a high risk for skin cancer. Between 10:00am and 3:00pm, solar intensity is at its highest, and consequentially, the risk is greatest. There is a 4% increase in sunlight intensity for every 1000 foot rise in altitude above sea level. Generally speaking, our best defense is the liberal use of sunscreen with an SPF above 30 and to always wear a hat. It is also important to remember that prolonged sun exposure causes photoaging in which the skin loses elasticity causing a dry, wrinkled leathery appearance that is cosmetically unappealing and very difficult to correct. In other words, the best treatment is ALWAYS prevention.

With spring on the horizon, we also see a significant increase in interest in cosmetic interventions both surgical and non surgical. I suppose as the days grow longer and the sun starts to shine, our focus often shifts to maximizing how attractive we want to look and feel. In my practice, I see an increase in surgical consultations and procedures between April and September. Some of this is related to vacation time and school schedules. However, some of it due to our brains awakening after the long dark winter.

As always, we advise patients to plan well ahead when contemplating surgery. While we strive to do our best, there are occasions when we cannot accommodate the last minute request.

Have a great spring – remember lots of sunscreen and wear a hat!

Dr. John Keohane