Warning: Your web browser is outdated, which may cause this website to display improperly. Click here to update.

Blog MD

All posts by Timothy Janiga

Double Chin? Kybella To The Rescue

Isn’t it a wonderful surprise when something takes less time than you hoped it would? Like when your plane leaves on time and touches down 15 minutes early, which means more beach time for you. Or, how about when something just works the way it should? A lot of our patients are experiencing just that with Kybella, a 45-minute in-office procedure that dramatically reduces the appearance of a double chin. While the FDA suggests it could take up to six treatments to be effective, most people find Kybella banishes their dreaded neck wattle in as few as two or three treatments.

Here’s how this terrific new product works.

Kybella - Rid Your Double Chin
Recently introduced by Allergan, the same company that produces Botox, Juvéderm, and Voluma, Kybella is an injectable that takes enzymes from your own body called deoxycholic acid and breaks them down into a form that can be injected under your chin. The FDA-approved product is injected into your submental fat pad, where the enzyme breaks down fat cells. The result? Permanent removal of that pesky double chin.

Patients who undergo Kybella injections at Janiga MDs can expect a very short procedure – usually 45 minutes or less from start to finish. As with other injectables, you may experience some mild discomfort after the procedure, generally lasting around an hour. After that, expect bruising for up to a week and swelling for another week or so beyond that. Once the swelling is gone, voilà: No more double chin! If a second or third round is needed, we generally space treatments out, with two to three months between office visits.

In our experience, Kybella is truly a great noninvasive option for anyone looking for a more defined jawline. Not long ago, the standard approach was to use liposuction for double chins, but Kybella has changed the game, making it even quicker and easier to achieve your ideal look. Cost for Kybella treatment varies, but ranges from $600 to $1,200 per treatment and depends on the size of the fat pad. To discuss whether you’re a good candidate for Kybella, set up a free consultation with Dr. Jennifer Janiga today.

This post was last updated on .

No More ‘Trout Pout:’ 5 Noninvasive Cosmetic Treatments For Fall

Trends come and trends go, with many of them serving as passing fads that don’t last more than a season. Others, however, are worth a closer look. One such trend in cosmetic surgery and dermatology is the movement toward noninvasive procedures.

Unlike traditional surgery that requires patients to be checked into a surgery center or hospital to be put under, noninvasive procedures are performed in-office under local or topical anesthesia. Noninvasive treatments are the most rapidly expanding area in cosmetic surgery, with a 158 percent increase in the last 15 years, according to the American Society of Plastic Surgeons. Because of this dramatic rise in popularity, we’d like to highlight the top five noninvasive procedures to consider this fall and beyond.

Perioral and Periocular Rejuvenation

As we mature, so does our skin. A loss of bone, fat and volume in the face may cause a sunken appearance around the eyes or pinched appearance of the mouth for both men and women starting in their 40s.

With time, our lips begin to lose volume and as a result lines begin to form around the mouth and nasal labial folds. Juvéderm and Voluma are fillers that can be successfully used to treat these concerns, without lips appearing overly plumped, pinched or fish-like. At Janiga MDs, we are sensitive to this and are always trying to help our clients achieve the absolute best look for their age.

Juvéderm and Voluma are used to build up the loss in volume and bone around the nose, mouth, pre-jowl sulcus and chin to help improve the overall appearance of lines as well as the lips. With this technique, very little filler is used into the actual lip, thus avoiding the dreaded “fish lips” or “trout pout” appearance we all so desperately want to avoid.

Dr. Timothy Janiga recently performed this procedure on Dr. Jennifer Janiga, resulting in a natural, younger-looking appearance of the mouth and lips.

Juvederm & Voluma

Similar to the area around the mouth, the area around the eyes is just as sensitive to bone, fat and volume loss. Loss of volume around the eyes manifests itself in the form of bags or a hollowing appearance under the eyes. This happens as we age, with the first signs appearing, for most, around the early 40s.

To treat this area, we leverage products similar to the ones used to treat volume loss around the mouth, both Juvéderm and Voluma. These products are injected around the eye and the cheek bone to provide contour and lift to the areas effected by volume loss.

Dr. Jennifer Janiga has performed this procedure on our Physician’s Assistant Melanie Buckley, resulting in more youthful eyes.

Non-Invasive Cosmetic Treatments


As we’ve discussed in previous blog posts, miraDry is a great alternative in treating underarm sweating. With just one treatment, underarm sweating can be reduced up to 82 percent. Most people require only one treatment, and experience a significant reduction of sweat, hair and odor.

The procedure takes an average of an hour and a half to two hours and is ideal for the cooler months of fall and winter, so that you may be sweat-free come next spring.

Botox or Dysport

Botox and Dysport are neuromodulators that inhibit the muscles of the face and can be used to treat crow’s feet, frown lines between the eyes, forehead lines and even those annoying bands that form on the neck. These procedures take no longer than 15-30 minutes with very little downtime, making it perfect for patients on the go.


Intense pulse light is the ideal procedure for treating brown and red areas on the face. Brown spots and blood vessels appear on the face through excessive sun exposure. But with just one treatment, you will see up to a 50 percent reduction in brown spots and blood vessels. This laser treatment is ideal for the fall and winter months, as patients need to refrain from sun exposure for six weeks prior to the procedure.


A fat destroyer, Kybella is a new product designed to dissolve the fat pad that tends to form under the chin as we age. Injections are performed in office, and, on average, take up to three treatments resulting in permanent shrinkage of the fat pad of up to 80 percent. Kybella treatments are performed right in our office with little to no downtime, making it a great option for many patients.

Dr. Timothy and Jennifer Janiga evaluate and treat patients who desire these, as well as other, noninvasive procedures in their Reno/Tahoe offices. To schedule your consultation, please send us an email or call (775) 398-4600 today.

This post was last updated on .

Dr. Timothy Janiga Nationally Recognized by The American Institute of Plastic Surgeons

Dr. Timothy Janiga

As many of our clients may already be aware, Dr. Timothy Janiga is a technically-gifted plastic surgeon, dedicated to producing only the best results. In addition to his highly respected credentials, Dr. Janiga is also an incredibly nurturing physician, who treats each of his patients as if they were family and not just a mere procedure.

That is why we at Janiga MDs are proud to announce that our office has been nationally recognized for being the best in terms of quality of service as well as customer satisfaction.

Dr. Timothy Janiga recently accepted an award presented by the American Institute of Plastic Surgeons (AIOPS) as one of their 2016 10 Best Plastic Surgeons in Nevada for Client Satisfaction.

The AIOPS is a third-party rating organization that publishes an annual list of the top 10 plastic surgeons by state. Surgeons who are selected to appear on the list must pass a rigorous selection process, which is based on patient/peer nominations, thorough research and AIOPS’s own independent evaluation. The annual list was created as a resource to help guide patients during their surgeon selection process.

One of the most significant aspects of the selection process involves the evaluation of a surgeon’s relationship with or reputation among his or her patients. As patients should be a surgeon’s top priority, the AIOPS places the utmost emphasis on selecting surgeons who have achieved significant success in the field of plastic surgery without sacrificing service and customer support.

At Janiga MDs, we take great pride in producing work that is not only of the highest quality but which helps each of our clients to achieve their own desired results. We are proud of Dr. Janiga and all that he has accomplished within the field of plastic surgery, and congratulate him on his most recent achievement.

To schedule your private one-on-one consultation with Dr. Timothy Janiga call our Reno office at 775-398-4600 or emailing us today.

This post was last updated on .

Fat Grafting For A More Youthful Appearance

While many cosmetic surgery patients are eager to find ways to rid their bodies of fat, some are looking to add it in all sorts of places you might not expect. The procedure is called fat grafting and, unlike liposuction, fat grafting is aimed at adding – rather than subtracting – volume to your face, buttocks and other areas.

Fat Grafting

Facial Fat Grafting

Probably the most commonly requested area for fat grafting is the face. As we age, it’s natural to experience thinning lips, prominent nasolabial folds, hollowing around the eyes, cheekbone and temple areas. The resulting loss of facial volume leads to a long, hollow expression and can make other parts of the face appear saggy. With fat grafting, we remove fat from other parts of the body and use it to re-balance the youthful proportions of your face.  At Janiga MDs, we routinely place fat in patients’ temples, cheeks, nasolabial folds, marionette lines (in the corners of your mouth) and lips to give them a fuller appearance through revolumization.

There’s also an added benefit to fat grafting that’s not often discussed. In many patients we’ve performed the procedure on, we’ve noticed an improvement in their skin’s texture tone and vitality. Our belief is that this is a result of the stem cells that are transferred with the fat, giving a boost to the appearance of the skin.

In most cases, we combine facial fat grafting with a facelift, but the procedure can be performed alone, as well.

Fat Grafting In Buttocks

By now, you’ve heard of the Brazilian Butt Lift, the now-famous procedure that gives patients that much sought-after Kim Kardashian look. The look is achieved through grafting fat into the buttocks. As we age, our buttocks lose projection and can sag or become flat. Even if you’re not looking for a larger backside, fat grafting can still help give you a more youthful looking rear.

Fat grafting is nothing new. It has been around for quite a few years, but the technology we use for it has advanced, allowing us to use micro cannulas to place the fat very specifically into small areas of the face. It’s also hard to overlook the added benefit of the stem cells that are transplanted, improving overall texture of the skin. If you’re looking to turn back the hands of time (or at least make them run a little more slowly), Dr. Timothy Janiga for a consultation, we can discuss fat grafting and explore other cosmetic options tailored to your needs.

This post was last updated on .

What Type of Tummy Tuck is Right for Me?

Tummy Tuck

One of the advantages of plastic surgery is that it affords patients the flexibility to customize their procedures to realize an ideal look. A great example of this being the tummy tuck. The tummy tuck surgically removes excess skin and fat resulting in a smoother looking abdomen. Whether you’ve experienced significant weight loss, childbirth or just want to tighten up your mid-section, a tummy tuck may be the perfect solution for you.

At Janiga MDs, we offer our patients two main types of tummy tucks. In simple terms, one procedure moves the bellybutton while the other does not. The first of these – the full tummy tuck – tends to be more involved and is for people hoping to remove larger amounts of tissue, fat and skin. At the start of the procedure, we make an incision around the bellybutton, then make another from hip to hip to remove any extra skin and fat. At this point, we reposition your bellybutton and place sutures around it. The full tummy tuck has more incisions compared to its counterpart, the mini tummy tuck, but is necessary for certain patients. You can expect a little more downtime after undergoing the full tummy tuck: recovery ranges from three weeks for regular activities to six weeks for exercise and vigorous activities.

The second type of tummy tuck we offer, known as the mini tummy tuck, is less invasive, using an incision along the same line as a C-section, avoiding the belly button completely. This type of tummy tuck is ideal for both men and women who may be bothered by excess skin or a small protrusion below their bellybuttons. Because we make fewer incisions during this procedure, the mini tummy tuck is less extensive and has less scarring, but is only appropriate for certain patients. Similar to the full tummy tuck, recovery ranges from three weeks for regular activities to six weeks for more vigorous activities.

The great news about a tummy tuck, whether you choose the full or mini, is that both can be combined and performed simultaneously with other cosmetic procedures such as breast augmentation, breast reduction, liposuction, repair of the abdominal wall muscles or even a facelift or rhinoplasty.

Curious whether you’d benefit from a tummy tuck? Schedule a consultation today with Dr. Tim Janiga to see if you’re a candidate for a full or mini tummy tuck, or if a combined procedure is right for you.

This post was last updated on .

Exploring The Varied Costs of Plastic Surgery

When you’re considering plastic surgery, there are a lot of questions that inevitably swirl around in your head: Is this procedure safe? How long will it last? What’s my recovery time? But often the biggest question comes down to money, namely, “How much will this plastic surgery procedure cost me?” To answer this question, we’ll break things down between noninvasive procedures, in-office cosmetic procedures and surgery center-based procedures, each of which varies in price and financing options.

shutterstock_146561927-min (1)

Noninvasive Cosmetic Procedures

These include procedures such as Botox and Dysport, injectables such as Juvéderm, Radiesse and Restylane, as well as lasers, miraDry and peels. Each of these procedures is performed in office, allowing you to return home the same day with minimal side effects of bruising or peeling. Recovery time with these procedures is short, lasting from a day to a week. Factors in the price of these cosmetic procedures include the cost of the actual product combined with the office staff and the length of time it takes to perform. Most of these procedures range from $240 (one area of Botox) to $3,000 (resurfacing laser.)

Office-based Surgery
All of the surgical procedures at Janiga MDs are performed by our board certified plastic surgeon, Dr. Timothy Janiga. Included in this category are procedures such as mini facelifts, small area liposuction, upper eyelid lift (blepharoplasty), lip lift, scar revision, earlobe reconstruction and other smaller, minimally invasive procedures. These are all performed in our Reno office under local anesthesia and do not require putting you completely under. In most cases, you’ll experience a one- to two-week recovery period. With office-based surgeries, we determine the price based on how many staff members we use along with the cost of technologies/supplies used (i.e. the liposuction machine for lipo procedures). Because we perform these procedures in-office, they generally cost less than their surgery center counterparts, ranging from $1,500 for scar revision to $9,000 for longer, more involved procedures such as an in-office facelift.

Traditional Surgery
Not all procedures can be performed at our offices. Some, such as endoscopic brow lift, complete facelift, tummy tuck, breast augmentation, rhinoplasty, Brazilian butt lift, large area liposuction and others must be performed in a fully accredited surgical center, complete with an anesthesiologist who puts you to sleep for the duration of the surgery. The reason for this is that these procedures generally take longer than most patients can tolerate being awake. Also, the area being treated is too large for local anesthesia, which can be toxic at the doses that would be required for these procedures. Often, patients will ask if we can perform procedures such as breast augmentation in office to avoid the cost of surgery centers and anesthesiologists. While some doctors might do this, Dr. Janiga is firm in his belief that you should be in a full surgical facility when having these types of procedures done.

When you receive a quote for your specific surgery, it usually is broken down for you into surgeon’s fees, implant fees (if applicable), facility fees for the surgery center and anesthesiology fees.  At Janiga MDs, we bill you for one single fee, which includes the anesthesiology and facility fees in order to streamline your transaction. The minimum cost of full surgery is $4,500 and ranges upward of $25,000, depending on how much time your surgery takes. Although this is the most expensive option, it’s a small price to pay to ensure that your vital functions are constantly monitored during surgery.

Financing Options
At Janiga MDs, we set you up with a preoperative appointment a week prior to your surgery, at which point you will pay in full for your surgery. Janiga accepts Alpheon Credit, Care Credit, most credit cards, as well as check or cash. There are multiple financing options available, including those through Care Credit and Alpheon, which allow you to decide how much you can afford each month for up to five years. If you go with one of these options, you need to make arrangements for the financing well in advance of your surgery so everything is set for the day of your pre-operative appointment.

If you are interested in financing or want to discuss whether any of these procedures are right for you, please contact us for a consultation where Dr. Janiga will discuss options specific to your case.

This post was last updated on .

How Old Is Too Old For Plastic Surgery?

How Old Is Too Old For Plastic Surgery?

Here’s a question I get asked a lot: “how old is too old for someone to have plastic surgery?” Before I answer that, let me break the question down into two distinct ideas. The first concept is that there is an average age range for specific procedures – breast lifts, for instance. The second, trickier question, is whether there’s such a thing as “too old for plastic surgery.”

Let’s explore this. With a procedure such as breast augmentation, the typical patient age range includes women in their twenties and early thirties. A Mommy Makeover, on the other hand, tends to be performed in peak childbearing years, or around a woman’s mid-thirties to her early fifties.

In our practice, we have what’s called a bimodal distribution (two separate ranges) for procedures such as rhinoplasty, which sees peaks in patients in their early twenties and rising again for those in their forties and fifties. With facelifts, we tend to see patients – both male and female – who are over 45, but a mini facelift or in-office facelift can certainly be performed on people who are younger.

These age ranges should hardly be considered limits on having a procedure done. Rhinoplasty is a type of procedure that can be performed at nearly any age. Rather, we look at these numbers as mere averages that help us know our clientele better. There is such a thing as too young for plastic surgery, which we’ve previously discussed and feel passionate about as a practice.

So, back to the heart of the question: can you be too old for plastic surgery? In short, the answer is no. If you are healthy enough for surgery, we do not place age limits on our procedures. Someone who is very healthy and in their seventies would make a great candidate for nearly all of our procedures and we’d welcome them at Janiga MDs.

A word of caution: there are a few reasons to avoid surgery at any age. These include:

  • Blood clots
  • Heart problems
  • Lung issues
  • Kidney failure
  • Severe reaction to anesthetics

I’d welcome the chance to discuss whether you’re a candidate for any of our plastic surgery procedures. Please contact me, Dr. Timothy Janiga, at 775-398-4600 or schedule a consultation online.

This post was last updated on .

Planning Your Cosmetic Surgery With Digital Imaging Tools

3D Imaging

For years, cosmetic surgeons have tapped into the power of the photographic image to better understand their patients’ needs and to highlight the successful results of procedures. Think of the impact a really good before and after photo can have on a patient’s confidence. Images have the ability to crystalize a moment in time and, when used correctly, can even help us understand ourselves better.

Traditional Imaging
At Janiga MDs, we use traditional photography as well as innovative 3D imaging to give you a better idea of what’s going on with your body both before and after your procedure. With traditional photography, we’ll take a patient’s photo right before surgery, then follow up with another image a few weeks or months post-surgery. This becomes an important part of your medical record, and it helps us to identify problem areas for you and your surgeon. Of course, we are also happy to share these images with our patients, as they make the perfect testimonial for the work we do here at Janiga.

3D Imaging
The type of imaging we will focus on today is 3D Vectra Imaging, which is not only the wave of the future, but a great way for us to image patients for many procedures, including breast augmentation. With breast augmentation, the 3D imaging helps patients visualize the size and shape of breasts they want long before we make a single incision.

Here’s how it works: with this technology, we take a picture of your body and then digitally model the size and shape of implants you’re considering onto the image of your body. This not only helps with visualization, but it ensures that the surgeon and patient are on the same page when it comes to the results of the procedure. In fact, that’s one of the biggest patient concerns we see. People are naturally curious to know what they’ll look like after the procedure. Now, patients can see various implant shapes, such as round, teardrop, high-, medium- and low-profile, eliminating the confusion over all the implant options out there. This adds a real comfort factor to the procedure, by removing the fear that the patient’s breasts won’t come out the way they’d hoped.

While we certainly do traditional photography with all procedures, there are some that really lend themselves to 3D imaging, such as breast lift, breast augmentation with a lift, the aforementioned breast augmentation, tummy tuck and rhinoplasty.

If you’ve been considering any of these procedures, I encourage you to reach out to me, Dr. Timothy Janiga, to schedule a complimentary consultation and 3D imaging session. We’ll discuss your needs and expectations in our first visit and go over both surgical and non-surgical options.  I want you to not only look great, but feel great, too. Imaging is just one small part of our approach to helping you achieve your desired look.

This post was last updated on .

A Closer Look at Four Trends in Cosmetic Procedures

Cosmetic Procedures

Not long ago, we mentioned that cosmetic and plastic surgery procedures are on the rise in the United States, with nearly 2 million procedures being performed annually. As we look over the data from the American Society of Plastic Surgeons, a few really interesting trends are starting to emerge, and we’ll explore them here.

When you include non-invasive procedures, the number of cosmetic procedures has nearly doubled since 2000. What’s driving this uptick? Muscle inhibitors such as Botox, Dysport and Xeomin are leading the way, while fillers such as Voluma, Juvéderm, Restylane and Radiesse come in a close second. We regularly perform each of these procedures at our Reno office, with patients experiencing very little discomfort. As with most procedures, you can expect a few days of swelling or bruising after your visit. Based on the number of these non-invasive procedures my wife, Dr. Jennifer Janiga, has performed lately, it’s fair to say Reno and northern Nevada are keeping up with the national trends.

Another trend worth noting is breast augmentation, a surgical procedure that remains the most popular among all cosmetic surgeries. Breast augmentation is followed closely by Liposuction, nose reshaping, eyelid surgery and tummy tuck. Each of these is a standard cosmetic procedure and should be performed by a board-certified plastic surgeon in an accredited operating room facility. And, as we’ve previously mentioned, it’s crucial for you to find a plastic surgeon that understands all your needs for you to have the best experience in the long run.

A trend that’s really skyrocketed over the past couple of years is butt implants, better known as the Brazilian butt lift. The look – made famous by celebrities such as Kim Kardashian and Sofia Vegara – is achieved by surgically grafting fat from areas such as the abdomen, flanks or thighs and injecting it into the buttocks. Using a fat graft rather than an actual implant helps give a more natural look. This procedure was so uncommon in the early 2000s, that the American Society of Plastic Surgery didn’t even track it. That’s all changed, with a recent 200 percent increase in these surgeries over the last couple of years. Safe to say this procedure is on the ASPS’s radar now.

Finally, let’s look at the trend of “lifts.” These can be performed on several areas of the body to help combat the effects of gravity, weight loss or changes due to pregnancy. One example: an alternative to traditional breast augmentation is a breast lift with augmentation, where excess skin is removed and the areolar complex is repositioned into a more youthful position. We fully anticipate there to be an increase in breast lift, thigh lift and facelifts in the coming years.

As we watch a lot of trends ebb and flow, we like to keep the procedures that remain consistently popular the mainstay of our practice. If you’d like to explore whether any of these invasive or non-invasive procedures are for you, please call us to schedule a consultation with us today.

This post was last updated on .

Spring Into Outdoor Fun, But Don’t Neglect Your Skin

Ah, spring. It’s the time of year when our thoughts turn to baseball, golf, that unrivaled Tahoe spring skiing and generally spending more time in the great outdoors. All healthy pursuits, to be certain, but with the lengthening of the days and inevitable warming trends that they bring comes a reminder that long-term exposure to the sun – whether it’s sitting on the beach at Sand Harbor, planting a garden or riding your bike around the McCarran loop – can seriously damage your skin.


As northern Nevada golfers and other weekend warriors get into the full swing of spring, here are a few reminders about the unique aspects of our region and how to deal with them.

The Truckee Meadows is situated at approximately 4,500 feet above sea level, meaning the sun exposure you get here is of a greater magnitude than in the Bay Area or most anywhere else in the nation. Sun exposure manifests itself in many different ways, but prevention should always be your first line of defense. At Janiga MDs, we strongly recommend you always wear a sunscreen of SPF of 30 or higher and reapply it every two to three hours. Another easy step is to wear a wide-brimmed hat and SPF protective clothing for the duration of your time outdoors.

Still, even the best methods of prevention can fall short. Over the course of a lifetime, we accumulate quite a bit of sun exposure. Sun exposure causes changes in the color or pigment of the skin. This damage can lead to broken blood vessels and the appearance of brown spots (lentigos) on your skin. This can result in the premature appearance of aging, especially on the face. These are treated quite nicely with Intense Pulsed Light, which is a simple 15-30 minute office procedure. The laser provides a combined treatment for both brown and red areas, which is perfect for people with significant sun exposure.

Chronic sun exposure also can cause solar elastosis, or a breakdown of collagen and elastin in your skin. These changes can manifest themselves in a couple of different ways. First, the skin can develop a bumpy texture or crosshatching, with lines going off in all directions. This gives skin the unfortunate resemblance to an orange peel. This phenomenon occurs most commonly in fair skinned people who’ve had significant sun exposure. The second possibility with solar elastosis and collagen degradation is laxity, which manifests itself around the jaw line through sagging skin or jowls.

The good news is that we can help you overcome many of these issues through a few simple procedures we offer here at our Reno offices. For the orange peel look, skin resurfacing lasers such as our ICON Ablative Resurfacing Laser can go a long way toward improving the appearance of these areas. For the issue of laxity, we would recommend either a full facelift or mini facelift to improve the overall appearance of the skin. Call it the Golfer’s Makeover, if you like. Either way, we think you’ll be thrilled with the results.

In addition to offering each of these cosmetic procedures, we carry a full array of sunscreen and other preventative skincare products to help reduce your risk of sun damage this spring and summer. To see if one of these products or procedures is right for you, feel free to schedule a consultation with us any time. With these tips in mind, get out there and enjoy the great northern Nevada outdoors!

This post was last updated on .