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Blog MD

All posts by Timothy Janiga

How Young is Too Young for Cosmetic Surgery Procedures?

There’s been a lot of hype and interest in some of the young starlets having cosmetic procedures performed at very young ages; sometimes even younger than 18-years-old. While each situation is unique – and there are specific times where cosmetic surgery can be performed for patients younger than 18 – my general rule is usually 21 or older.

Let’s first discuss some of the special circumstances that might allow someone under 21 to have a cosmetic procedure. First and foremost, parental consent is required for patients younger than 18, except those who are emancipated adults. If that consent has been obtained, some special circumstances that might allow cosmetic procedures for people under 21-years-old would include genetic abnormalities of the chest wall, hypoplastic (underdeveloped) breasts, abnormalities of the jaw bones that would impede normal chewing and development, deviated septum in the nose preventing breathing, disfiguring scars after an accident, or other abnormalities that prevent normal growth and development or are psychologically damaging.


Interestingly, the FDA will not allow silicone breast implants to be placed in anyone younger than 22, even if they are born with genetic abnormalities or disfiguring medical conditions. Fillers such as Restylane and Juvéderm are not approved for anyone under 22. Botox and Dysport are approved for 18 and older. All of the above factors need to be considered in addition to a young person’s mental health, parental involvement and long-term safety.

For adults older than 21, some factors are less complicated. When you’re 18, you are considered a legal adult and can consent to surgery. The FDA will allow fillers and silicone implants for adults over 21, so those issues are removed from the equation. But, whenever I am considering an operation on a young person – whether it be for strictly cosmetic purposes or for developmental abnormalities – there are many factors to take into consideration.

Please make an appointment with me, Dr. Timothy Janiga, so we can discuss both your personal situation and what is most appropriate for you.

~ Dr. Timothy Janiga

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How to Maximize Your Cosmetic Surgery Results

You’ve done the research, you’ve saved for the procedure and now you’ve finally pulled the trigger on the cosmetic surgery procedure you’ve wanted for a long time. Now what? I am often asked by my Reno plastic surgery patients, “What can I do to get the best results from my surgery?”

There are two ways to answer this question: the short answer and the long one. Today, we’re going to give you both.

Reno Cosmetic Surgery Results

The short answer:

The best thing you can do to maximize your outcome after surgery is to follow your pre- and post-operative instructions diligently. There are a lot of things that we are not able to control or predict when it comes to cosmetic surgery, but for everything that we can control and predict, we like to try to make sure those things happen.

The long answer:

When you book a surgery with Janiga MDs, you are provided written and verbal detailed pre- and post-operative instructions. It is very important to follow these instructions carefully to maximize your results.

The instructions before surgery include preoperative tests that vary by procedure, like a mammogram, bloodwork, abstaining from certain medications while making sure you take others. We ask you to get a good night’s sleep beforehand, as surgery is taxing on the body. It’s also important to have a good support system in place ahead of time so someone else can care for your basic needs while you recover.

Postoperatively, you will receive similar printed instructions, as well. These include details about when to restart your medications, as well as any food restrictions, how to take your medication for discomfort, phone numbers to call in case of emergency and approved activity level after surgery.

This last one is important. Often we hear from patients who feel good and would like to be more active than our instructions state, but it is crucial to your recovery that you refrain from too much activity too soon. Patience is key to achieving the best results from your cosmetic surgery procedure.

Many factors go in to a surgical procedure and maximizing outcomes. As a patient, your most significant contribution to this surgery is your full participation in the before and aftercare.

Call our Reno plastic surgery offices any time to discuss your cosmetic surgery needs. You can trust us to provide you with the best comprehensive care available.

~ Dr. Timothy Janiga

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The Benefits of Having Dermatology and Plastic Surgery in the Same Office

The specialties of dermatology and plastic surgery complement each other exceptionally well. We like to say that where one begins, the other ends, but it is a continuum. At Janiga MDs in Reno, most of our patients take advantage of both the plastic surgery and the dermatology side of the practice.

janiga mds reno

One great example of how plastic surgery and dermatology work together is in how we treat patients who are looking for an anti aging affect for their face. From the plastic surgery side, we can treat those larger issues that require surgery like removing excess skin, tightening underlying structures, and removing fatty deposits. From the dermatology side, we can improve the texture and tone of the skin, improve volume with fillers and help with fine lines and wrinkles.

At Janiga MDs, our patients enjoy a well-rounded approach to treatment. For example, all of our surgery patients receive a gift certificate to have a complimentary consultation with my wife our dermatologist, Dr. Jennifer Janiga.

During this consultation, they can talk to Dr. Jennifer about how they can maintain their youthful appearance after surgery and into the future. When she meets with people after I have operated on them she will advise them about skin checks, brown spots, fine lines and wrinkles and what products would best work for them. Often times these surgery patients will opt to receive lasers, botox or filler to complete their anti aging goals.

The reverse is also true. A lot of our dermatology patients will see Dr. Jennifer Janiga for many years and then decide that they would like to have surgery. Lasers, filler, botox and product are great for maintenance of the skin, but sometimes the only thing that will fix laxity issues is removing and lifting the skin, and that’s where I come in.

By having both dermatology and plastic surgery in the same office, we can offer a well-rounded approach to procedures and skin care. Many times I will see a patient for surgery and let them know they are not ready for that extensive of a procedure and my wife will perform a less invasive treatment for them. This holds surgery off sometimes forever and other times for a few years.

This combined all-inclusive approach allows our patients to get the best long-term result as possible with the best approach for their individual needs.

Call our Reno plastic surgery and dermatology offices any time to set up your consultation. We can help you decide if you should see Dr. Jennifer Janiga in dermatology or myself, Dr. Timothy Janiga in plasic surgery (or both).

~ Dr. Timothy Janiga

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Breast Augmentation with a Lift vs Just Breast Augmentation

Many women come for a consultation and are not sure if they need a breast augmentation alone or a breast augmentation with a breast lift (also called a mastopexy augmentation). Most women would prefer to have the augmentation alone and hope that this would give them enough of a lift, but this is not always the case.

These are two completely different surgeries that I will try to differentiate today.

breast augmentation with a lift

Breast augmentation is performed for women who would like an increase in the size of the breast, but are less concerned with lifting the breast. A breast augmentation or boob job procedure is performed by using an incision either under the breast, around the areola, or in the armpit where an implant is inserted through the incision. The volume of the implant does give some lift effect, but this is not its primary purpose.

Breast augmentation with a lift also called mastopexy augmentation is usually necessary in women who are looking for a larger size and a lift in the position of the breast. Many have lost a significant amount of weight, have been pregnant multiple times, or have a natural genetic tendency to have pendulous breast tissue.

A breast lift with augmentation entails more incisions than breast augmentation alone. The anchor incision is the most common type but vertical lifts are also possible, decreasing the number of visible scars. The excess skin is removed and the nipple areolar complex is repositioned to be in a more youthful position. Before closing the tissue, the implant is placed to help with size.

You can see some amazing breast augmentation and breast augmentation with a lift/mastopexy augmentation before and after photos on our website.

It is difficult to know whether you will need a breast lift with augmentation or a breast augmentation alone, come to our Reno plastic surgery office for an evaluation with Dr. Timothy Janiga to see which of these procedures is best for you.

~ Dr. Timothy Janiga

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Transformation Tuesday: Patient Before & After

For this month’s before & after transformation we chose a patient who had a treatment plan that was customized to her specific needs. As with all of our Reno plastic surgery patients, we evaluate this patient’s needs and requests to create a treatment protocol that fit her needs.

In this patient’s before photo she has a significant amount of laxity in the lower face and neck, requiring a facelift, but one of the things that also really bothered her was her upper lip.

facelift before

Many people will advise filler or fat grafting to this patient’s upper lip, but this case is a more difficult one. This is a perfect example of a woman with a naturally aged and very thin upper lip. No matter how much filler or fat you place in this upper lip you will not get the results you are looking for. You will get that characteristic overfilled duck shape lip that we all dislike.

This patient received an in-office face and neck lift, which had minimal recovery time, and an in-office upper lip lift. An incision was made below the nose and a portion of the skin was removed.

mini facelift after

You can see that this gives her the natural shape of her youthful upper lip back and a beautiful Cupid’s bow shape.  No filler or fat was placed in the lip, the before and after are 6 weeks apart and she has nothing but her natural anatomy.

Come visit our Reno plastic surgery office and have a personalized one-on-one consultation with me.  We can discuss if you need one of our customized procedures including lip lift, in office facelift, earlobe repair, or possibly revisionary surgery from previous operations.

~ Dr. Timothy Janiga

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Two Tummy Tuck Transformations by Dr. Timothy Janiga

With my line of work, often seeing is believing. That’s why today we are profiling two of our patients who underwent drastic tummy tuck transformations. These women have very different body types, so you can see how plastic surgery can benefit just about anyone.

Our first transformation comes from a patient with extra skin on the abdomen from having multiple children. The laxity of the skin in this area is very common after the stomach has been stretched multiple times from pregnancy. As you can see this woman would not be able to lose anymore weight or do any more crunches to improve her stomach. Her skin was not able to regain its tightness and elasticity.

A tummy tuck to remove this extra skin was performed allowing her to have a flat stomach once again. The photo shows her stomach before surgery and three months post operation.

Tummy Tuck Before and After

In our second before and after plastic surgery photo features a patient that had about 5 pounds of tissue removed from the abdominal area to give her back a flat and more appealing stomach. Additionally in this patient a small amount of liposuction was performed to improve the contour.

The photo below shows the transformation of the patient’s stomach from before to three months post operation.

Tummy tuck and liposuction before and after

Tummy tuck and sculpting procedures can be performed for women of different sizes, shapes, and anatomy. As you can see from these two examples sometimes only skin needs to be tightened and other times a more extensive procedure with contouring can be done.

Make an appointment at our Reno plastic surgery office and see how I can tailor body procedures specifically to your body type.

~ Dr. Timothy Janiga

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Plastic Surgery Procedures with the Least Recovery Time

With our busy and hectic lives, most of us are looking for improvements with the least amount of recovery time missed from work, hobbies, and social activities.  Studies show that adults today have the least amount of free time of any previous generation.

One of the very first questions I am asked by patients at our Reno plastic surgery office is “how much time do I need to be off of work or out of social activities to have this procedure?”

All of the surgeries that we perform require some amount of rest afterward, but there is a great variation in downtime from treatment to treatment. Today we will go through a few of the plastic surgery procedures with the least amount of recovery time for all you busy folks out there.

Plastic Surgery Recovery Time

In-office facelift

The in-office facelift uses local anesthesia, so you do not go completely under.  There is minimal bruising with this procedure and in most cases and the stitches are removed in a week.  Most people are back to mild activity or work from home within three to four days.  Of course there’s no heavy lifting on or other strenuous activities for about three weeks, but most people can resume the majority of their regular activities after one week.



In the office, localized liposuction can be performed on the small areas under local anesthesia, so you do not have to go fully to sleep. This can be performed for small pockets of fat on the abdomen or lateral thigh as well as the love handles on the mid back.

Downtime for this procedure is approximately a week also, but most people can be sitting and doing deskwork within three or four days.  Again, with this procedure there’s no vigorous activity or heavy lifting for about two to three weeks afterwards.

Breast Augmentation

This procedure is a surprisingly fast recovery. It is performed in the operating room, but has one of the quickest recoveries. With breast augmentation most can return to light activity in a week and more strenuous within three weeks.


Arm Lift Surgery

A brachioplasty, or arm lift surgery, is also performed under general anesthesia and has two variants: a modified version and a full. The modified version is less downtime, and is a more conservative procedure. Not everyone is a candidate for the modified brachioplasty, but with this version you could be back to work and most regular activities within a week.

Each plastic surgery procedure is different and each person has a different rate of healing, so most of these are general rules. Please come in for a specific consultation at Janiga MDs Reno Plastic Surgery for your needs and we will work together to find the best procedure for your specific body type and lifestyle.

~ Dr. Timothy Janiga

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Treatment Spotlight: Rhinoplasty or Nose Job

The face is the first thing people see when they meet us, and the nose is one of the most prominent features on the face. For this reason, when the nose is crooked, overly large or has other aesthetic abnormalities, it can cause a person to be self-conscious.

Thankfully, Rhinoplasty or a nose job is one of the most common cosmetic surgical procedures. I see patients of all ages and both genders for this surgery in my Reno Plastic Surgery office. These patients are relieved to hear that the issues with their nose can be fixed.

There are two main types of rhinoplasty or nose job surgeries, closed and open. A closed rhinoplasty is usually performed for dorsal hump abnormalities for crookedness.  The closed rhinoplasty is performed through the nostrils with no external scars.

An open rhinoplasty is done through a small incision under the nose. This type of rhinoplasty is done when the patient needs more work done on the tip of the nose for a bulbous tip, tip deviation, or asymmetrical nostrils. A crooked nose, deviated septum, or a dorsal hump can also be fixed this way.

The recovery from a closed rhinoplasty is slightly less then for an open rhinoplasty, but the recovery time ranges between 2-4 weeks for bruising, but can take over a year for the full results to show as it takes quite a while for the swelling of the nose to completely dissipate.

Every patient has individual needs, and every nose is unique. Make your complimentary consultation to see whether an open or close rhinoplasty is better for you.

~ Dr. Timothy Janiga

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Top Three Patient Transformations

When it comes to plastic surgery, often, seeing is believing. With that in mind, we decided to do a quick round up of some of our amazing cosmetic surgery transformations to share on today’s blog post.

1. Facelift and Fat Grafting

Fat Grafting Reno Facelift Reno

This patient received a transformative facelift and fat grafting. The facelift incision was made in front and behind her ear to give her a face and neck lift. Look how smooth and tight the neck area looks after.

The fat grafting was done around the mouth to help the fine lines in the nasabial folds to decrease their prominence, and to the cheeks and lips to give back that youthful and fuller look.

2. Nose job or Rhinoplasty

Nose Job Reno

A nose job or rhinoplasty can be performed for completely cosmetic reasons and also at times for breathing and structural issues. In this photo you can see the dramatic difference in the before-and-after in the shape of this patient’s nose.

Dr. Timothy Janiga improved the appearance of the top of the nose down to the tip, which has been raised and repositioned giving her face a completely different appearance.

3. Tummy Tuck

Tummy Tuck Reno

This woman had a few children and she was back to her pre-pregnancy weight, but was unable to get her tummy to be flat again.  The muscles in her abdomen had spread open with her pregnancies and in addition to a small amount of skin to be removed, she needed the stomach muscles tightened down the middle, this is called the diastases.

The tummy tuck procedure allowed the skin that had been stretched with pregnancies to be removed. It also repaired the diastases, which allowed her to have her waistline back. The scar is very low across her lower abdomen and is covered with most bathing suits and underwear. The recovery for a tummy tuck is between 2-6 weeks with restrictions on lifting more than 20 pounds for the full 6 weeks.

You can see many more of our patient before and after photos on our website. If you’re interested in your own transformation, call us any time to set up a consultation in our South Reno plastic surgery office.

~ Dr. Timothy Janiga

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24 Hour Breast Enlargement – How Does it Work?

Recently a patient in our Reno plastic surgery office asked me about a segment she saw on Good Morning America about a 24-hour breast enlargement. The segment highlighted a new treatment protocol coming out of New York City that promises women an instant breast enlargement with no down time, but that only lasts 24 hours.

After watching the video and investigating a bit, I determined that the treatment essentially is saline being infused into the breast tissue for a temporary increase in bust size. Saline is the normal fluid that we use when we put an IV in a patient at the hospital or emergency room and is a safe substance in and of itself.

As noted in the video, the cost of this procedure in New York City is approximately $2,500. The saline will last in the breast tissue for about 24 hours, and then will diffuse to the rest of the body and be absorbed.  The saline itself should not cause any problems in the body when it diffuses to be absorbed.

Women in the segment said they paid the hefty price tag in order to get a boost in breast size for a special occasion like a vacation or night out. Others used the temporary enlargement to experiment with size before undergoing breast augmentation surgery. Indeed, if a 24-hour improvement in bust size is what you are looking for, this procedure would work nicely.

Of course, with any procedure there is a risk of infection when you cut the skin to insert the fluid, but overall this procedure is safe if performed under a sterile atmosphere and by experienced hands.  One word of caution however, when you insert anything into the breast you do create scar tissue and therefore, multiple and repeated procedures such as this could increase the scar tissue in your breast.

If you are interested in Reno breast augmentation, call our offices to set up a consultation. We can discuss your long term (or temporary!) goals and set up a treatment plan that’s right for you.

~ Dr. Timothy Janiga

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