Get the Best Skin of Your Life: Fractional Laser Resurfacing Treatments

If you're looking for a highly effective means to reverse age spots, wrinkles, or lax skin, fractional laser resurfacing treatments just might be the solution. Fractional laser resurfacing is actually two different types of procedures (ablative and non-ablative) and they are able to correct mild to major skin issues ranging from age spots to deep wrinkles and more. Though both ablative and non-ablative laser resurfacing can improve your skin greatly, they have significant differences.


Ablative lasers (such as the CO2 or Erbium) can help eradicate your skin concerns such as deep wrinkles, loose skin, pigmentation discrepancies and acne scarring and the best part about this is you can expect drastic results. With an ablative laser you'll require only one treatment, but they are considered a bit invasive and thus it can take up to 4 weeks or more to recover. These lasers actually vaporize the outer layers of your skin, removing the outer layers of aged or sun-damaged skin, which causes it to restructure itself as it heals and increase collagen production. Anesthesia and pain medication are usually used during and after the procedure, and it's not without risks, which can include swelling, redness, infection, skin color changes, scarring and more.

What you can expect:

This is an outpatient procedure. Prior to the procedure, your face will be cleansed and your eyes will be covered. Local anesthetics or sedation will be used to numb your skin and keep you comfortable. An intense beam of light energy will destroy your epidermis and simultaneously heat the underlying tissues to cause collagen fibers to shrink and heal, forming new skin that's smoother, tighter and fresher looking. The treatment can take up to two hours, depending on the technique used and the size of the area treated.

Post-procedure your skin will be raw, swollen and might even ooze. Your doctor will protect it with ointment and might also cover the area with a special dressing. It could take up to two weeks or more for new skin to cover the area and several months for lingering redness to go away, but once it's completely healed you can expect your new, smooth complexion to last for years.


Non-ablative lasers (such as CoolTouch and Fraxel) are a less invasive experience than the ablative ones since they rejuvenate from the inside out rather than the outside in. They're often used to treat concerns such as fine lines, lax skin, minor pigment discrepancies and uneven texture. These lasers actually bypass the top layer of the skin, heating up the sub-dermal tissue in order to cause a cellular response that initiates healing mechanisms and increasing collagen production. They require minimal downtime, but can take several sessions in order to achieve perceptible results. They heat up the underlying tissue without entirely destroying it, while allowing your body to stimulate collagen production to help reduce imperfections. To minimize discomfort, a topical anesthetic is usually applied prior to treatment and you can usually apply your makeup immediately after your procedure to minimize any temporary redness. The plus side is that there's minimal to no downtime and the risks of infection, color changes, redness, swelling or scarring is greatly reduced. If your skin concerns are mild to moderate, a non-ablative laser resurfacing treatment could help restore your younger-looking self with little to no discomfort. I have plenty of friends who have undergone this procedure and stated that it’s a relative breeze with pretty significant results.

What you can expect:

This procedure is usually performed in your doctor's office. Before beginning, the area to be treated will be cleansed, your eyes will be covered and a topical anesthetic will be applied. Your doctor will apply a special cooling spray, gel or cool air to the treatment area to keep the outer layer of your skin protected before pulsing the laser. The laser will cause damage to (but not destroy) the collagen beneath your skin, stimulating new collagen growth and a tightening of the underlying skin. This procedure can take as little as 15 minutes or more than an hour, depending on the technique used and size of the area treated.

Post-procedure, you'll want to use ice packs to minimize any temporary redness or swelling. Though less dramatic than ablative lasers, your results from non-ablative lasers will be gradual and progressive with increased improvement in your skin's overall tone and texture.

Generally, the greater the results you're after, the stronger you want your laser to be and the longer your recovery will take. Certain skin issues like age spots and fine lines can be corrected with a non-ablative laser, but bigger issues like deep wrinkles and scars will require the stronger ablative laser. If you have fine to deep lines and wrinkles, lax skin, acne scarring or age spots schedule a consultation with a board-certified plastic surgeon to determine if either ablative or non-ablative fractional laser skin resurfacing is the right choice for you. Patients who have had laser skin resurfacing give it a 95.4% patient satisfaction rating. To learn more about the procedure and read patient reviews, visit the procedure page.


Read the original article at
The Mommy Makeover – Is It Right For You?

Being a mom is one of the most challenging, frustrating, yet rewarding experiences a woman can have. You put forth blood, sweat and tears, not to mention an untold strain on your whole body during pregnancy. It really boils down to the genetics of your skin and fascia as to how well you can bounce back after the weight gain and abdominal stretching from your baby. Many women lament that despite dieting, exercising and lots and lots of willpower your body is never the same as it was prior to child bearing. Fortunately, for the masses of dissatisfied women, there are options in Plastic Surgery to boost your self-confidence and your body image. Here is a list of body corrections (Mommy Makeover) that can be performed in tandem or separately to improve the shape and how you feel about your physique.


During pregnancy, the glandular component of the breast must enlarge to ready for the enhanced production of milk. Additionally, weight gain with fat storage all governed by the hormonal changes can increase the breast size immensely. Unfortunately, fetal regulation also makes skin "stretchy" to accommodate the increased girth of the breast and abdomen. After the resumption of normal non-pregnant hormones and the lack of need for lactation, the breast volume will revert back to baseline and can even reduce in overall size compared to the original baseline. Unfortunately, many times the skin does not have the ability to shrink to the original size and will stay expanded resulting in a larger skin brazier with same or even less fill than before resulting in "saggy" breast shape. With increased skin length from the breast fold to the nipple it moves the breast mound lower on the chest with less upper pole fullness. I hear many women call their breasts "sad" in appearance when they come in for consultation. Okay, enough depressing thoughts... what can be done? If the skin is not excessively enlarged, the nipple-areolar complex is correct and the fold to nipple distance is not greatly elongated, the solution can be to place a silicone gel implant to act as a shaper and a filler of the breast envelope restoring a pleasing breast shape. If the breast has a low positioned nipple-areolar complex, with or without increase skin length from the fold to the nipple-areolar complex, then a mastopexy (breast lift) is required. Often times tissue volume might need to be enhanced to provide better shape and upper pole fullness, thus an implant or fat grafting can be incorporated at the same time. Sometimes upper pole fullness can be accomplished by transposing extra breast tissue in the lower pole and positioning it on the chest wall deep to the rest of the breast to enhance fullness.


Hormones during pregnancy direct adaptive body changes that allow healthy growth of the baby, but unfortunately create lasting changes to a women's body. The abdominal skin stretches and often can result in stretch marks (tears in the dermis with intact epidermis). Excess skin rarely retracts in these cases, leading to hanging skin that drapes over the pelvis. Next, the abdominal wall is distorted to accommodate the growing fetus resulting in separation of the paired rectus muscles leading to increased abdominal circumference with permanent bulges in the abdominal wall both above and below the umbilicus. This unfortunately cannot be reduced with abdominal exercise because the stretched fascia between the muscles is not contractile and will not respond to muscle strengthening. Additional weight changes with aging often can be manifested with increased abdominal girth from excess fatty tissue. So what can a Mommy Makeover achieve in the abdomen?

If skin quality is excellent and the abdominal wall is only minimally distorted often liposuction with the addition of additional energy sources such as ultrasonic energy (VASER), oscillating power hand-piece (PAL), or hydraulic power can result in removal of excess fat and create skin retraction/redistribution to improve contour. However, many women will need a full abdominoplasty with correction of excess fat with liposuction, removal of excess lower abdominal skin with tissue resection, and abdominal wall restoration by returning the rectus muscles together with a permanent suturing technique. This can result in excellent contour of the abdomen but you will trade the contour for a scar. I find most people are surprised how long the scar has to be to create the contouring necessary. Once acquainted with the results, most women will gladly trade a scar for the results of a flat smooth abdomen.

Back and Flanks

Some women can realize their goals by correcting the anterior abdomen by itself. However, many women if given the opportunity would love to three dimensionally correct their torso by sculpting their midback (bra line folds) and flanks (muffin tops) at the same time as their abdomens to circumferentially adjust their shape. This can make a tremendous change on how clothing can be worn and how the individual feels about themselves. Liposuction with either PAL or VASER makes a great deal of improvement by releasing all the ligamentous attachments between the back and flanks and the superficial skin (which results in rolls on the back) and allows even removal of fat and the skin to re-drape much smoother.


Some women naturally store adipose tissue in their lateral or medial thighs. Depending on the skin quality and the potential for the tissue to re-drape or tighten, fatty tissue can be sculpted just as on the back. Some have significant adipose tissue below the knee down to the ankle. I generally do not add the additional power source with liposuction in this area and have achieved good results.


Popular trends in body shape can change just like in fashion over time. The introduction of the Latin culture into the United States in conjunction with pop culture personalities have made the appearance of a full contour buttock something to aspire to. My preference for buttock augmentation is with fat grafting and not with a prosthesis. Utilizing concepts of tissue equilibration and liposculpturing we can remove unwanted fatty tissue, harvest it as a graft, and utilize the fat as a volumizer of the buttock, all while improving the contour of the rest of the body. Women who have gained and lost weight may have loose sagging skin of the buttock and restoring volume can shape and lift the buttock with little or no scarring.

Women who are unhappy with their physical appearance after giving birth to one or multiple children can restore the body to a better place with a Mommy Makeover. To me this represents more than one area of the body to be rejuvenated simultaneously to make the woman feel refreshed and erase some of the "battle scars" of pregnancy so she can feel more confident in her appearance.


Read the original story at the Plastic Surgery Post

The iDoctor

You may have heard of the iDoctor, but, if not, watch this video to the end! It's a real eye-popper!

Mommy makeovers: Getting your body back
 If you've heard the term "Mommy Makeover," you may assume that it's a new type of plastic surgery to help recent mothers get back their pre-pregnancy shape. While that's partially true, the term actually refers to a number of different surgeries, often performed at the same time. Each woman's body will experience different effects after giving birth, so deciding what type of plastic surgery your Mommy Makeover will consist of is something you should discuss during your consultation with a board-certified plastic surgery. The top three cosmetic surgery procedures in 2012 were breast augmentation, liposutcion and tummy tucks, which are the three procedures that make up the standard Mommy Makeover. These procedures focus on improving the figure and giving women back a sense of control and self esteem.

Procedures for the breasts
One of the most common issues after childbirth is a change in the size or shape of breasts, according to the American Society of Plastic Surgery. There are several different types of procedures that can help treat this issue. Breast implants may be the most well-known, but implants to increase size may not be the best move after childbirth. Instead, many Mommy Makeovers consist of a breast lift or breast augmentation to change or enhance the shape of the breast.

Keep in mind that if you are breastfeeding your infant, you'll want to wait until you've weaned him or her to prevent any issues. Often, it's the very act of breastfeeding that may change the breasts shape. A breast lift can help treat a bust that is sagging due to changes that come with age or childbirth.

Procedures for the tummy
Not surprisingly, carrying a child for nine months can have a profound effect on the shape of one's stomach. While many women will naturally lose weight with exercise and diet after they give birth, more often they have a problem with sagging skin left over. That's why a tummy tuck, rather than liposuction, is usually part of a Mommy Makeover. This procedure can help remove excess skin and restore a more natural, thinner appearance.

Procedures for the lower body
Diet and exercise may not always solve the changes that come with having children, and often women will experience weight gain or shape changes in their lower body that they can't fix on their own. Liposuction is one way to remove stubborn fat from the stomach, thighs or buttocks. Other patients may choose a lower body lift, which tightens sagging skin around the thighs, hips or buttocks.

Is it worth it? patients give the Mommy Makeover a 98% positive rating and numbers reflect increasing numbers of Mommy Makeovers.

Please take a look at our Before and After Mommy Makeover gallery and also these Before and after photos of tummy tuck with breast surgery:

Breast Reconstruction Awareness Day

The doctors and staff of Dunagan, Yates & Alison Plastic would like to recognize National Breast Reconstruction Awareness Day.

We celebrate the women who inspire us... brave women who meet adversity head on, and the nurses and loved ones who care for these brave women! To our patients and women everywhere who are battling breast cancer... we salute you!

Aging gracefully: Tips and advice for general maintenance



Patients who come into our office might have one or more procedures in mind, but in general, they want to look good for their age and slow down the aging process. From keeping skin looking smooth and bright to helping their weight-loss goals by minimizing problem areas and contouring the figure, there are many options available. Every plan starts with a healthy lifestyle, filled with a balanced diet and regular exercise.

When people talk about getting older, it's not uncommon for them to use the term "aging gracefully." Often, celebrities like Helen Mirren or Diane Lane are described this way, because they are beautiful older women who don't seem to be going out of their way to hold on to their youth. But, celebrities aside, how does the common woman grapple with the concept of aging gracefully when we get so many mixed messages about what it means to grow older?

Are you speaking in code?
"Aging gracefully" is often used as a euphemism. People may use the phrase to mean, "Looking old, but embracing it" or "Showing signs of aging, but still powering forward with life." In this way, the term feels almost negative or backhanded - it's the phrase we use to describe someone who isn't looking as good as they once did.

But is that the only interpretation we can affix to this term? Perhaps aging gracefully doesn't necessarily have to refer to age or appearance, but rather the attitude people have as they go through the various stages of life.

The best of both worlds
"Aging gracefully" has also been a word used to describe women who choose to grow older without undergoing any aesthetic procedures to help them maintain their looks. This perspective, however, feels a bit outdated. There was a time when plastic surgery was a taboo subject, but today, it's gained wide acceptance, because people have realized that there truly are benefits to cosmetic procedures. They can help you not only look younger, but also feel more confident.

Aging gracefully doesn't mean you have to wear your wrinkles with pride - instead, you need to do whatever is necessary to stride into your older years with confidence. For some people, this may mean simply embracing the natural signs of aging without visiting a board-certified plastic surgeon along the way. For others, it means taking steps to make your outside appearance match the way you feel on the inside. If you feel energetic and youthful internally, then there's no shame in getting a facelift, tummy tuck or breast lift to keep your body at the same level.

Ultimately, it comes down to personal needs and desires. If you are confident about getting plastic surgery, then electing to go under the knife is the most graceful choice you can make.

Below are some articles and links about procedures that can help you age gracefully.

Aging Gracefully: Face
A man or woman who has already had a facelift, eyelid lift or rhinoplasty is going to be happy with their new look after surgery. They have addressed a major problem area that was causing them issues. Once that is corrected, there may be procedures that can help them continue to put their best face forward.
* Nonsurgical procedures for anti-aging
* Sleep is a major factor in keeping skin looking young and fresh
* Injectables can help you look more approachable

Aging Gracefully: Hands
Many people don't realize that their hands age along with their body until it's too late. Wrinkles, sunspots and loss of fat and volume can be gradual or if you're like most, hit overnight when you realize you haven't used gloves enough or put sunscreen on your hands.
* News article addressing hand rejuvenation
* Information about hand rejuvenation

Aging Gracefully: Body
After a breast augmentation, tummy tuck or body lift procedure, most are excited about their new physiques and feeling confident. Are there areas where liposuction or nonsurgical fat reduction could help? Cellulite or spider vein treatment?
* If one part of your body is bothering you, liposuction can help
* Cellulite doesn't have to be something you have to live with now
* Are dark veins making you feel self-conscious about your legs?

Cosmetic Trends: Fads vs. Truths



There are articles and advertisements online, in print and on television everyday talking about the latest device, product or technique that will get you fast results for cheap. This extends from the most extensive surgeries, like a facelift to smaller treatments like a facial or noninvasive laser. Most of the claims should be taken with at least a grain of salt, but some shortcuts and claims could lead to more serious complications like hospitalization and corrective surgery. If it sounds too good to be true, it probably is. Exercise caution.

Facials, creams and potions
Snails, bird poop and gold are just a few things that have made headlines on ingredients for anti-aging treatments that focus on good skincare recently. Here are a collection of articles discussing these strange fads and alternatives like microdermabrasion, laser skin resurfacing and chemical peels.

- Latest skincare fad: Live snails?
- Study: Gold in your skincare products accelerates aging:
- Will bird poop facials take off as a new skincare fad?

Lunchtime facelifts
There are many ways to lift a face and some patients do well with a mini-lift with minor incisions and a quick recovery, but most of this cannot be achieved over an hour lunch. Injectables and skin resurfacing treatments is more appropriate for that time frame. See some patient safety articles that can spurn some good conversations.

- 3 questions to ask before committing to plastic surgery:
- Lifestyle Lift changes national ads after probe:
- Branded Surgery Is Not Always the "Quick Fix" it is Advertised To Be:

Illegal injections
Perhaps the most alarming trend is the increase in illegal injections of potentially toxic and unverified products from unlicensed individuals due to the popularity of buttock augmentations and Botox. It seems like there's a news story every week about the arrests of these unscrupulous criminals who prey on vulnerable patients who do not have the resources and information to make better decisions. Share these stories as a cautionary tale and let patients know how they can make the best choice for their situation.

- Mother-daughters arrested for illegal Botox injections:
- Putting the medical end of your medispa under the microscope:
- Woman sought for administering plastic surgery without a license:

Watch Dr. Mike Yates on WHNT 19 as He Discusses Healing Time!

DYA's own Dr. Mike Yates discusses healing time for popular plastic surgery procedures on WHNT 19 News at 5:00.
I've got to do something about my face, but what?



Years ago, it was easy. You chose from a menu of forehead lift, eyelift, midface lift, cheek implants, rhinoplasty, facelift, chin implants and liposuction, which might be coupled with a skin resurfacing treatment. But now, almost each surgical procedure has a noninvasive counterpart to treat the same problem.

The marriage of technology and imagination has spawned a supermarket of noninvasive procedures that claim to iron out wrinkles, lift, chisel, plump and remodel. With a less expensive price tag and less downtime, the issues related to noninvasive procedures boil down to: “What results and how much longevity can I get from noninvasive treatments?”

It’s a good idea to know all your options before you visit us. Your ideal procedure will be based on your facial features, skin quality, ability to tolerate downtime, economic resources and aesthetic sensibility. You can’t make these choices alone. Drs. Dunagan, Yates or Alison will guide you based on a facial assessment supported by years of experience treating patients with similar concerns and facial features.

Though the surgical options are more expensive, the nonsurgical treatments will need to be repeated, so it is up to you to do the math. Here is a sampling of some of the surgical facial procedures and their noninvasive counterparts that are currently available:

Brow Lift or Botox?

Surgical. A brow lift, also called a forehead lift, corrects skin wrinkling and drooping that causes your eyebrows to sag and excess skin to hood your upper eyelids. It can soften the deep creases across your forehead and reduce the horizontal frown lines at the top of your nose and the vertical lines between your brows.

Nonsurgical. Botox, Dysport and Xeomin are neurotoxins that relax the muscles underneath the skin to prevent wrinkle formation. They are FDA-approved to treat the “elevens,” – those lines that form between your brows. They have also been successfully used to treat horizontal forehead lines, crow’s feet, tiny bunny lines on the side of the nose and can give your eyebrows a gentle lift.

Eyelift, Soft Tissue Fillers or Your Own Fat?

Surgical. Upper eyelid blepharoplasty removes the excess fat and sagging skin of the upper eyelids that can make you look tired or sad and corrects a puffy upper eyelid appearance.

Lower eyelid blepharoplasty eliminates under eye bags, excess lower eyelid skin and fine crepe-paper type wrinkles, dark under eye circles and lower eyelid droopiness. The result is a more alert and rested appearance.

Nonsurgical. Injections of Botox, Dysport or Xeomin can minimize Crow’s feet. When injected above the eyebrows, Botox or Dysport can also provide a ten-degree lift to the arch and a slight lift to the tail. To get rid of under eye depressions (bags), your plastic surgeon can inject your own fat or a hyaluronic acid, such as Restylane, into the area. An autologous fat injection (your own fat) usually lasts longer than hyaluronic acid, which will last up to a year.

Cheek Implants, Fillers, or Your Own Fat?

Surgical. Cheek implant surgery can make your cheekbones more pronounced and attractive, replace lost cheek volume (due to aging and weight loss) and fill in hollowed-out cheeks. Cheek implants vary widely in material, size and shape and can be custom made to suit you.

Nonsurgical.  Autologous fat is commonly used to build-up the cheeks. We can take fat from areas such as the belly or thighs and meticulously inject it into the cheek area. This is commonly used as an adjunct to facelift. Filler injections (Restylane, Perlane or Juvederm), or a collagen stimulator (Sculptra or Radiesse) are also great cheek enhancement options. In addition to balancing your face, injectable facial fillers will lift your cheeks to create a youthful appearance.

Rhinoplasty or Injectables?

Surgical. Rhinoplasty can reshape your nose to remove a nasal hump and reduce an enlarged tip. It can also improve the angle between your nose and upper lip. If your nose has drooped with age, rhinoplasty can lift it.

Nonsurgical. A Botox or Dysport injection in the divider between the nostrils can also lift the tip of your nose. Bumps on the nose can be minimized with injections of soft tissue fillers. In some patients, tissue fillers are added to increase nasal volume where desired.

Facelift or Injectables?

Surgical. A facelift can reverse the effects of gravity, tightening deeper tissues, firming up excess loose skin and addressing the volume changes that occur with aging. Liposuction can remove excess fat under the neck.

Nonsurgical. Injectable soft tissue fillers can be used to lift and diminish jowls, lift corners of the mouth, and minimize wrinkles, folds and lines. Injections of Botox or Dysport can be used to make neck cords recede. Necklines can be softened with mini doses of hyaluronic acid fillers in combination with Botox or Dysport.

It is important to know what’s available, so you can get more out of your plastic surgery consultation. But not every option is appropriate for every face. Your next step is to get the benefit of your plastic surgeon’s trained eye. He will identify the procedures that will produce optimal results for you.

Watch DYA's Dr. Deason Dunagan as he discusses Summer Skin Care on WHNT 19 News!

Revision Skin Care for Men
Just in time for Father's Day, stop by DYA's Skin Health and Laser Center for Revision's skin care regimen for men!
Revision Skin Care Regimen for Men
Dr. Bill Alison in "Downtown Living" Magazine

Congratulations to DYA's Dr. Bill Alison, who is featured in the May 2013 issue
of "Downtown Living" magazine. 


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