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Category Archives: Plastic Surgery

Growing Popularity in Plastic Surgery for Men – What Are the Trends?

According to a report from the American Society of plastic surgeons, there were 15.6 million cosmetic procedures in 2014. Of these procedures, 1.7 million were surgical and 13.9 million were considered minimally invasive. We talk a lot about cosmetic procedures for women, but for November, we’re going to focus some attention on the other half of the population: men.

The top five cosmetic surgical procedures for men in 2014 were nose reshaping, eyelid surgery, breast reduction, liposuction and facelift. The top five minimally invasive procedures include Botulinum Toxin Type A (Botox, Dysport, or Xeomin), laser hair removal, microdermabrasion, chemical peels and fillers.



From a surgical perspective, nose reshaping or rhinoplasty can be performed in most age groups and is usually a procedure done to improve the overall contour or size of the nose. The width length or a type of dorsal hump can be improved with rhinoplasty. Eyelid surgery candidates are usually a more mature population, who seek help with laxity in the skin on the upper eyelid or bags or laxity on the lower eyelid. Breast reduction in men can be performed after massive weight loss or in men with abnormal tissue called gynecomastia. Liposuction is the fourth most common procedure performed on men. It can be performed on the flanks or abdomen to reduce fat deposits. Rounding out the top five is facelift, which is a similar procedure for men and women, but special care must be taken in men because of their hairline.

For minimally invasive procedures, the overwhelming top spots goes to the botulinum toxin type A with more than 400,000 men receiving this procedure in 2014. Botulinum toxin inhibits muscle movement and is commonly performed to decrease lines in the area between the eyes, the forehead and around the eyes on the sides. Other areas that can be treated include the jaw muscles, which can be prominent in men. Botulism toxin can be used to inhibit some of the muscle contraction in this area, thereby decreasing the thickness of the muscle improving the contour of the face. Laser hair removal is usually performed on the beard area or other areas such as the back where hair is undesirably located. Microdermabrasion and chemical peels are usually performed by an esthetician associated with a plastic surgeon or dermatologist. Rounding out the top five are soft tissue fillers. Men with a desire for improving the lines around the mouth, or giving a lift to the cheek area are interested in soft tissue augmentation such as Juvéderm, Restylane or Voluma.

I’ve included a few before and after pictures specifically for men, but if you would like a consultation for any of these surgical or minimally invasive procedures, please call our office at 775-398-4600 and make an appointment for your complementary consultation.

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Are you a good candidate for breast revision surgery?


There are many reasons to have revisional surgery for the breasts. Having previous breast augmentation, breast lift, breast reduction, or surgical procedure such as breast biopsy or lumpectomy may make you a candidate for a revision.

Breast augmentation revision can be performed for patients who would like a different size implant or a switch between saline and silicone. These procedures can also be performed for someone who may want to switch out a silicone implant for one of the new gummy bear silicone implants. Over time, the concept of ideal breast appearance can change for an individual. As women mature, their bodies change. Additionally, women may decide they want the breast to be smaller or larger. This is the most common reason for breast revision surgery after breast augmentation.

If you have had a previous breast lift, you may choose to have revisional surgery years later. As gravity has a continued effect on the breast itself, some people want to have their breasts lifted again. As women mature, have children, breast feed, have hormone changes and gain or lose weight, the breasts go through significant changes. Additionally, as women go through menopause, the dense breast tissue changes to a less firm fatty tissue adding to the sagginess of the breast. Another reason for revisional surgery after breast lift may be to improve unwanted scarring. With surgery, there is always a scar. At times, we can improve upon the look of a scar by revising it.

Breast reduction is another reason to have revisional breast surgery. There are many cases of women who have had breast reduction and, as the body changes with pregnancy, nursing, or maturing, they may have enlargement of the breasts again. This is usually related to weight gain or loss but may be a natural hormonal change for some women. A revisional breast reduction can also be performed if there is asymmetry in the breast from a previous procedure. If one breast is larger than the other or one is slightly higher, it can be made smaller or lifted higher.

People will also visit us for breast revision surgery after medical procedures that have been done to or around the breast which cause abnormalities in the contour. Revisional breast surgery can be done to improve the contour irregularities after breast biopsy, lumpectomy or from removal of other skin cancers on the breast.

If you have any questions or concerns regarding revisional breast surgery, please contact me, Dr. Timothy Janiga for your complementary cosmetic consultation.

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What is Otoplasty, and Who is a Good Candidate?


Otoplasty is a procedure performed on children and adults who would like to have their ears lay flatter against their head or who would like the shape of the ear changed. Most people believe otoplasty is only a procedure that pins the ear back to the head, or what’s called “ear pinning.” However, by definition it also includes procedures where the shape of the ear is changed. There are many reasons why people want to change the shape of the ear – including genetic abnormalities – but there can also be cosmetic reasons for the procedure.

When people are exposed to new social situations such as starting a new school, entering a new class, starting a new job or entering college, they may be exposed to a new set of people and feel uncomfortable if their ears do not lay flat against the head or if their ears have an abnormal shape. This is especially common in people with short hair and in those who wear their hair in a ponytail for particular activities. It may not have bothered the person when they were younger, but when these situations arise, ear shape or prominence may begin to bother them.

Otoplasty is performed in children to remove the prominence of the ears or to reshape an abnormally shaped ear the child was born with. With children, this procedure usually needs to be done in the operating room. The downtime after surgery is minimal, but anesthesia can make a child tired for about a week after a procedure.

For adults, both ear pinning and ear reshaping can be performed under local anesthesia in the office in most circumstances. The downtime is minimal, but for more involved cases there can be some discomfort for about a week.

If you or your child is having difficulty with the shape
or prominence of the ears, please call 775-398-4602 to make an appointment to see Dr. Timothy Janiga for a consultation.

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Medical tourism: approach plastic surgery abroad with caution


The trend of going out of the country to receive plastic surgery continues to increase. According to Patients Beyond Borders (www.patientsbeyondborders.com) over 1 million United States citizens traveled outside of the United States for medical procedures. The most common procedures are cosmetic dentistry, cardiovascular surgery, joint replacement surgery, fertility procedures, weight loss/lap band, and cosmetic surgery. Some of the most common countries that people travel to receive these surgeries are Costa Rica, India, Malaysia, Mexico, Thailand, Taiwan, and Turkey. The medical tourism industry continues to increase as healthcare costs in the United States increase. Deductibles for insurance are higher so patients are responsible for a larger portion of their medical costs, surgical facilities and hospitals are charging more for overnight stays and medication, visitation fees, nursing care, and postoperative care costs all continue to increase with time.

This discussion is not intended to disparage any other country or international physicians as there are a lot of great hospitals and great physicians locally and internationally, it is intended to educate you regarding the major risks of having procedures outside of the United States from my perspective.

Let us review some of the positives regarding hospitals, surgery centers, and physicians in the United States. Hospitals are regularly monitored by the government bureau called JAHCO. This agency will conduct surprise inspections, monitor infection rates, monitor patient volumes and readmission for complications. The hospitals in the United States must be accredited and certified in order to perform surgeries on patients with health insurance. Surgical centers whether inpatient or outpatient, must undergo similar accreditation by JAHCO and a separate surgical center accreditation to become an insurance certified surgery center. Physicians in the United States are monitored by their individual and respective boards, have to do continuing medical education in order to maintain their board certification, and can be researched on their state medical board website for certifications and disciplinary action. These are all safeguards put in place through the government and state agencies to ensure that the best safety measures and quality are provided to the patients in each state.

Internationally, there has been a movement to use the same American criteria for hospitals and surgery centers as an international standard. Our JAHCO will have its international version called Joint Commission International and the international surgical centers will also have a separate accreditation that should be closely equivalent to American standards. This criteria has been met by some international facilities. Physician certification in other countries varies by country. India and England for example follow a similar structure and certification, while some Asian countries have a completely separate way of certifying physicians as specialists that would perform surgery.

There are some risks outside of accreditations and certifications that patients should also be aware of. First and foremost is having to travel after having surgery. The postoperative recovery period varies for each type of surgery, but can range from a week to three months depending on how involved your surgery. Traveling on an airplane a short period of time after surgery can increase your risk of blood clots in the legs and may predispose you to bleeding or infection at a time while you are traveling and not able to reach a physician quickly. Additionally, postoperative complications are possible for months after your surgery. Most complications occur within the first three months, but it is possible to have new pain, infection, or an issue with an implantable device months to years after that surgeries been performed. If your physician is located outside of the country it will be difficult for you to find postoperative care especially for an immediate complication while you were traveling. Lastly, most health insurance plans now have provisions in their policies that they will not cover any complications from surgery performed outside of the United States. This means if you have a complication such as bleeding, infection, or a problem with an implantable device, any emergency services that you received in the United States afterwards maybe denied through your health insurance policy. Your health insurance wants you to have surgery at a contracted, accredited facility with a board-certified surgeon that has been vetted by your insurance company as an approved and credentialed physician in that specialty.

In conclusion, the motivation for having procedures outside of the United States is usually a financial motivation as it is less expensive in general to have procedures performed in other countries. However, safety is the utmost priority when it comes to your health and this should be your first and foremost consideration when making the choice to have an operation. There is no system that is perfect, including the healthcare system in the United States, but it is no coincidence that important figures from across the world travel here to have their surgeries performed, why would you go somewhere else?


– Dr. Timothy Janiga

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Cosmetic Surgery is on the rise. Will you partake?

Botox Injections

TIME magazine’s June 18 cover story was titled, “Nip. Tuck. Or Else. Why you will be getting cosmetic procedures even if you don’t want them.” After reading this article, I was excited to see some things mentioned, and I disagreed with one major point.

The concepts that I thought were covered well were numerous. The article also did a great job of talking about different types of surgeries and the different types of patients that are getting surgery in the U.S. The general idea that the old concept of hiding your procedures was mostly de-bunked and the new ideas of being proud of your choices were reviewed. The best part of the article, in my opinion, was the outline of the increase in cosmetic procedures. It is true that cosmetic procedures continue to increase every year as new technologies, less invasive procedures and great techniques improve. So, it’s little surprise we’ve seen a rise in procedures.

The one area that was covered extensively in this article that I disagreed with was the idea that plastic surgery is done – and will be done – because people are trying to keep up with their neighbors. In my practice, I do not find this to be true.

In general, most women (and men) come in to my office to improve a particular area that bothers them. The patient may be a mother who would like to get her pre-baby body back with a mommy makeover, a person changing career tracks and wanting to look their best with a facelift, or someone who has always been bothered by a particular area on the body such as the nose. Overall, my patients are everyday people with families and jobs who just want to look their best. These men and women are usually referred by a friend who has had surgery with me, but they do not come in because their neighbor had surgery.

The article in TIME is a good read, full of information, but a few areas should be taken with caution.

If you are considering plastic surgery, do it for you! Call us or go online to schedule a consultation with a board-certified plastic surgeon who can help you decide which procedures are best for you.

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Plastic Surgery Summer Trends


As summer enters full swing, we have seen an increase in body cosmetic procedures such as breast lifts, breast augmentations, abdominoplasty (tummy tucks), mommy makeovers, breast reductions and liposuction.

With warmer weather comes bathing suits, shorts and tank tops, bringing attention to parts of your body that may bother you. As a result, people start thinking about making improvements in these areas. Breast augmentation is common throughout the year, but tends to increase in warmer months and just before wedding season. Similarly, mommy makeovers, breast reductions, breast lifts and liposuctions become more common in the warmer months.

Wedding season, New Year’s, birthdays and the start of the summer months are just a few reasons (and seasons) that motivate people to come in for a cosmetic surgery consult. Whatever the motivation and whatever the season, Janiga MDs is here to give you the best opportunity to look and feel your best.

Get ready to hit the beach with confidence. Make your complimentary consultation with Dr. Timothy Janiga to see which of these procedures is best for you.

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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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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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