by James Haley, MD, FACOG, FPMRS

Holiday parties are here. Yes, it’s great to see friends and family – but it can be exhausting and sometimes downright stressful.

Whether you’re getting ready for family photos, the annual work party or a neighborhood get-together, a quick cosmetic treatment with Botox and fillers just might be the best gift you could give yourself this holiday season.

3 Reasons to Consider a Holiday “Pick-Me-Up”:

1. HELP! I know it’s normal, BUT… can I lose these crow’s feet and frown lines for just a little while?
Those pesky lines between your brows, or those little wrinkles at the corners of your eyes, are your badge of honor for living life to the fullest. But sometimes you might want them less…noticeable. Just one treatment of Botox can help smooth those lines away.

Botox is one of the most extensively studied esthetic treatments, used for facial injections to “freeze” muscles so they can no longer form habitual lines and wrinkles. The most amazing benefit of Botox is that facial lines and tell-tale signs of age are wiped away.

2. Finally, I can see my cheekbones! Now how about some baby fat to plump them back up?
As we age, fat may accumulate on the body, but it actually diminishes in certain areas such as the face, neck and shoulders. Dermal fillers help restore plumpness and lost fullness to relieve facial “furrows.” A filler is an injectable FDA-approved substance designed to take the place of lost fat beneath the skin. A single filler treatment will restore plumpness and fullness for a more youthful face.

3. I’ve got the holiday blues – can I have a little mood lift?
One of the most surprising effects of Botox has emerged from several recently published studies: the potential to relieve some depression (and not just because you look better).

Studies performed in Hanover Medical School in Germany in 2012 found that Botox injections in facial muscles involved with emotion eased the symptoms of depression. There appears to be a link between the emotions expressed by the face and the brain, a “feedback” cycle transmitted through the nerves. When Botox is injected into facial muscles, frown lines are not able to physically form. Our brains interpret the feedback from our facial nerves as more positive feelings. Three small subsequent studies from a researcher at Georgetown University appeared to confirm these findings.

Why Choose Cherokee Women’s Health Specialists?

Our double board-certified physicians know and understand a woman’s anatomy from head toe — and Dr. James Haley has been certified and trained in injectables since 2007 — so whether your reasons are 1, 2, or 3, Botox and dermal fillers can help you feel refreshed and renewed for the holidays.

Call today to schedule a free consultation at 770.720.7733.

Recently, one of our patients made the decision to have the liposuction procedure here at our office. She has chronicled her journey, and we had the pleasure of sitting down with her and learning more about why she made the decision, what reservations she may have had, and what life is like 3 weeks post-op.

Why did you want to seek out Liposuction? 

“I should preface my entire story by saying that I’m not overweight, I’ve never been overweight, but I have always had fat in very unwelcome places. A common misconception is that liposuction is for weight loss—it isn’t! It’s more for when you’re at your ideal weight, but you need to sculpt out the shape you want to be.

My trouble area has always been the “love handle” region. To add insult to injury, I have really high hip bones, so I’ve always felt like next to my long skinny legs and my long slender arms, my stomach had always looked like a tire.

When I heard that my trusted providers of Cherokee Women’s Health were going to start offering this procedure, I was very excited. I haven’t seen Dr. Litrel as my physician in all my years of annuals and during my pregnancy, he is very particular about who he surrounds himself with and the employees he hires, so I knew I could put my full trust in him in regard to my body sculpting goals.”

Were you scared about going through the procedure? What were your reservations?

“Truth be told, the pre-op appointment was, for me, slightly embarrassing. I planned for this though. I haven’t worn a bikini since the birth of my son, who is now two years old. Even before pregnancy, I was never fully confident wearing one, so having my stomach visible for someone to see, judge, and doodle on had me a little uneasy.

All of that aside, Dr. Litrel and his medical assistant Kami put me to ease quickly, even though to me, it looked like he was looking at my stomach as though he was solving the world’s most difficult puzzle. I watched him as he drew out a map and game plan on my stomach as though he could see clearly what my issues were and exactly how to solve them.

During the same appointment, Dr Litrel explained everything that would happen step by step during the procedure and what to expect for recovery. He also carefully laid out that, due to some of the more difficult to reach pockets of fat that I have on my body, I will likely need a follow-up procedure in about 12 weeks. When you have a physician that is completely honest like that, there’s truly nothing like it. I wasn’t expecting perfection from this procedure, more just improvement. I was even more impressed that Dr. Litrel seemed confident that after a second procedure, we could create the silhouette and curves that I both desired and deserved.”

Can you describe the procedure for us? What was it like?

“Since my procedure, the most common question that I get asked by family and friends is, “Did it hurt?”

There are plenty of liposuction resources online, and I believe that many resources can be overwhelming for people to think about in terms of pain and how the procedure is done. For me, the step was to inject a numbing solution into my stomach so that I wouldn’t feel any pain. The doctors waited about thirty minutes for the solution to fully kick in, and while I felt a little pressure, I didn’t feel pain. I was awake for the procedure, but the medicine that was moving through my IV made me loopy, and I was in and out for most of it. One moment that I do recall quite vividly, is having an itch on my nose and not being able to scratch it. I also remember trying to see what was going on throughout the procedure, and each time, the staff in the room would say, “Close your eyes and go back to sleep” in perfect unison.

After my nap, the next thing I knew, the nurses were assisting me in getting my new accessories for the first time. These girdles are necessary for me to wear during my recovery for the next few weeks, and they were explaining the steps of taking them on and off. One full body girdle sits just under my breasts down to just above my knee. It has a convenient hole in the bottom to make bathroom breaks easier. The other girdle is a binder similar to the one you receive after getting a c-section.”

Before and after shots of patient. After shots are 3 weeks post-op.

What does the recovery process look like?

“From the procedure room, the staff escorted me into a separate room to help me “Wake up” from the anesthesia. I was able to have my first few sips of water (something I’d been looking forward to since 7:00am!), and shortly after, my fiancé and son came back to check on me and then take me home.

Dr. Litrel came in to talk to me while I was waiting for my anesthesia to wear off, but I was told I kept giggling at him and then falling asleep, so he updated my fiancé on my after care and medication. The waiting for recovery felt like less than 10 minutes, but I was told it was closer to 45 minutes to an hour. The light anesthesia administered during the procedure makes the procedure an outpatient procedure, however I was having a little bit of difficulty staying awake in the recovery room.

Knowing that I am very sensitive to medication and anesthesia, I was given Phenergan in my IV during the procedure to settle my stomach (and also knock me out for the rest of the day so I could get some sleep afterwards).

On the way home, we stopped at the pharmacy and picked up my antibiotics and extra nausea medications, and I was homeward bound!”

What can someone expect from post-op?

“I slept the rest of the afternoon after the procedure and didn’t wake up from my Phenergan-induced nap until around midnight. I was amazed at how little pain I was in. Most of my discomfort was caused by the girdle and being unsure about moving around in it successfully. Standing up and sitting down in the girdle for the first few days gave he third trimester pregnancy flashbacks! 😊 I assumed that maybe the numbing solution hadn’t completely worn off yet, so I kept my guard up waiting for the pain to hit. I took extra strength Tylenol every six hours or so for the next 48 hours, not necessarily because I needed them for pain management, but more as a “just-in-case.”

I can thankfully say that I never got the pain I was expecting to feel afterward. I was sore, but unless my toddler crawled around on me, I never really hurt.

“By Sunday morning, my tiny incisions were done draining and had pretty much healed. I had minimal bruising, something I’m very thankful for. I didn’t have many post-op restrictions, so by the end of the weekend I was feeling well enough to clean my house.”

What have the first three weeks of post-op been like?

“I spent the first week with a little soreness. I was slightly uncomfortable, but mostly annoyed with the full body girdle. The opening at the bottom that I first found so funny suddenly was more frustrating than funny. Trying to find clothes that fit over the girdle was a little difficult, as it’s hard to hide a knee-length girdle under pants. (And I had the weirdest panty lines all the time!)”

What about the second and third weeks?

“By the second and third week, I had all but forgotten I’d even had the procedure done. Dr. Litrel approved for me to remove the body girdle but recommended that I continue wearing the other girdle for a while. By the end of the second week, I was starting to notice subtle changes in my stomach. It was visibly smoother, although I was still swollen. Dr. Litrel assured me that the swelling would go down but reminded me that the full results of the Lipo take up to twelve weeks.

Currently, I’m in my third week post-op and it feels like my procedure was performed months before. I am so excited to watch my body continue to change, and I am already feeling more confident thanks to Dr. Litrel and his amazing surgical team.”

This interview was completed three weeks post-op. We invite you to stay tuned as we continue to chronicle her journey after having the liposuction procedure done. If you’re interested in scheduling an appointment for liposuction, please contact our office to speak with our cosmetic services scheduling division at 770-720-7733.

You’ve done everything right! You dieted, exercised and finally lost all that extra weight you’ve been carting around. Or maybe you religiously followed all your doctor’s instructions to remain safely trim and as healthy as possible while pregnant. Yet, no matter how hard you worked at it, you’re stuck with that loose dewlap-looking fold of skin hanging around your tummy. It just won’t go away! You’ve researched and considered many available options, but realize your only remedy is probably a tummy tuck. You’re almost ready to commit to having one, but you still have questions.

At Cherokee Women’s Health Specialists, we understand and are more than qualified and happy to answer all your concerns, both in this forum and during your free consultation.

What is a Tummy Tuck?

A tummy tuck, or abdominoplasty, is a procedure that surgically removes superfluous skin and fat around the abdominal area distended by pregnancy, former surgery, obesity, accelerated weight loss, age, or heredity. It also repairs the slackened or separated muscles (diastasis recti) caused by these factors. In some cases, depending on their location, some abdominal marring such as cesarean section scars and stretch mark can even be eliminated. The result of an abdominoplasty is a firm, flat stomach and a more appealing profile without those unwanted bulges or bumps.

Are all Tummy Tucks the Same?

No, there are several different types of tummy tucks. The one is best for you depends entirely on your individual needs and desired results. Our experts will advise you accordingly, but the following are the three most common abdominoplasty methods:

• Standard or Full Tummy Tuck: This procedure addresses the area both below and directly above the navel (umbilicus). Under sedation, a predetermined incision, based on the amount of excess skin to be removed, is made horizontally between the hips. Another is made around the umbilicus, which is carefully excised for repositioning afterward. The abdominal skin is then pulled back. Damaged muscles are tightened and tissue is removed. Liposuction, if required, is performed, Remaining skin is tightly pulled together and closed. The belly button is then replaced in a centered position. The standard tummy tuck is usually the method used when there is a large amount of surplus skin and/or muscle weakness.
• Mini Tummy Tuck: This method is less invasive and only concentrates on the area of the lower abdomen beneath the belly button. It is ideal for slimmer patients with a slight bulge. Muscles are tightened and extra skin is removed, but there is no need for navel extraction and consequent readjustment.
• Circumferential Lower Body Lift: This is the most invasive tummy tuck procedure and the one that yields the most dramatic results. It not only encompasses the entire abdomen but also targets the lower back and hips, resulting in a total upper body reshaping. It requires both vertical and horizontal incisions, allowing the surgeon better access to more compromised muscle and excess tissue. Then liposuction is used to draw out fat located around the hips and lower back for a more defined silhouette. The belly button is replaced as in a standard tummy tuck before closing.

Because this is a more intense surgery requiring a longer period of recuperation, patients must be in extremely good physical health.

Am I a Good Candidate for a Tummy Tuck? 

You are a good candidate if you:

• Are in good health
• Are a non-smoker
• Are between 25 and 60 years of age
• Have good skin elasticity and muscle tone
• Have a great deal of loose, flabby skin: There must be enough skin to perform a standard tummy tuck so that the resulting scar does not become stretched and unsightly after healing. If you only have a small pocket of skin, the preferred choice is usually a mini tummy tuck.
• Realize that abdominoplasty is not a weight loss procedure or miraculous overnight makeover.
• Are committed to weight and good nutrition maintenance, a healthy lifestyle, and regular exercise
• No longer plan to become pregnant: Unexpected pregnancy after a tummy tuck is not harmful to a baby, but additional surgery to correct subsequent loose skin may be needed.
• Are within 15 to 20 pounds of your ideal weight with no plans to lose more.

Who Should Not Have a Tummy Tuck? 

An abdominoplasty is a low-risk elective plastic surgery, but surgery nonetheless. Full medical history disclosure is needed, including a list of all prescribed, over-the-counter medications, vitamins, herbs and supplements you use. Additional preoperative tests must be performed. Information from all sources is used to ensure that all precautions are taken to determine that you can safely tolerate the procedure. Possible reasons that make you a poor candidate are:

• An intolerance to the anesthesia
• Lung, heart, kidney, liver, or connective tissue issues
• A tendency to develop keloids or other thick scarring problems (hypertrophic scarring)
• Healing difficulties caused by certain medical conditions such as diabetes, coronary artery disease etc.
• A compromised immune system
• Obesity
• Poor circulation
• A tendency to form blood clots.

What is the Recovery Time After a Tummy Tuck?

Your surgeon is usually the best person to answer this question, based on individual factors and type of surgery, but typically the recovery time is 2 to 6 weeks. This is usually the time allotted before the patient can return to work unless the job involves heavy or rigorous activity. Otherwise, the recuperation may be longer.

Will I need to Stay Overnight After a Tummy Tuck?

Most tummy tucks do not necessarily require an overnight hospital stay, but some physicians–and patients–prefer it. You are usually physically able to leave within two hours.

I’m a Busy Mom. Can I Resume Care of Children After a Tummy Tuck?

It is crucial that the repaired muscles heal after an abdominoplasty. Any undue stretching of can cause tearing and stitch separation. Not only can this cause complications, but the desired abdomen flattening will not occur, rendering the whole process ineffective. You are usually cautioned not to lift anything over 10-15 pounds, and then, carefully. A wiggling toddler or baby can seriously jeopardize your healing process. Alternative, temporary accommodations, such as daycare or in-home help should be arranged.

What Precautions Should I Take After a Tummy Tuck?

Just as your doctor will explain exactly what preoperative preparations you will have to make, your aftercare needs will be explained. Some instructions you can expect are as follow:

• You will be prescribed pain medication and antibiotics with detailed instructions, and must not drive while taking it. Someone must drive you home.
• You will have bandages and drainage tubes that will require scrupulous care and attention. You may be asked to document drainage output to establish that you are healing properly. (Drainage from the incision site is normal, beginning with blood and some clotting. Discharge will slowly clear in color.)
• You will be told to avoid baths and hot tubs and be advised to take showers facing away from the stream.
• You will be restricted from heavy lifting and strenuous activity.
• You may be given compression garments to wear for about 6 weeks.
• You will have to refrain from sexual activity until your surgeon gives you the okay. (Some oral contraceptives taken with antibiotics may be less effective, so alternative birth control is recommended.)

You will also be told to watch for signs that may indicate a problem. Call your doctor immediately if you experience:

• Redness or swelling at the incision site (numbness is normal)
• Any fever over 101 degrees
• Foul smelling drainage or discharge
• Severe postoperative depression
• Blackening of the skin
• Excessive pain not alleviated with medication.

Why Should I Choose Cherokee Women’s Health Specialists for My Tummy Tuck?

You naturally want the most experienced and accredited surgeon to perform something as important as a successful tummy tuck. Our Drs. Haley and Litrel are board certified urologists who are doubly accredited in OB-GYN and Female Pelvic Medicine and Reconstructive Surgery (FPMRS). The latter certification was earned by meeting highly stringent criteria set forth the by the American Board of Medicine. Acquisition requires years of training and experience and enables them to perform all cosmetic and reconstructive surgeries dealing with women’s health, wellness, and self-image.

Cherokee Women’s Health Specialists is also affiliated with the new Northside Hospital Cherokee where your procedure will take place. This state-of-the-art institution provides our surgeons with impeccable surroundings and the most up-to-date technology known to modern science, ensuring that you will receive the highest quality care available.

The decision to have a tummy tuck is a serious one requiring much consideration and personal reflection. With proper professional intervention, investing in an abdominoplasty can be a permanent solution to an otherwise unyielding cosmetic problem, providing self-confidence and a sense of pride in your outer appearance for decades to come.

For a free consultation with one of our double-board certified physicians, call 770.720.7733 to make an appointment.

Lately, you’ve noticed that the rosy glow to your face is slowly disappearing, and a grayish tinge is replacing it. Your skin seems droopy. People regularly ask if you’re more tired than usual, even though you feel fine.

Upon closer scrutiny in the mirror, under bright, unkind lighting, you are shocked to realize that signs of aging are beginning to make an appearance around your eyes, mouth and a few other places.

Well, you’ll have none of that! You’re still too young, and you’re not about to look older than you feel, so you do some research, ask around and hear about something called Platelet Rich Plasma (PRP) Therapy –otherwise known as a Vampire Facelift. Though it sounds intimidating and, let’s face it, a little creepy, it’s a surprisingly simple, unique procedure with some amazing benefits.

What is a Vampire Facelift?

A vampire facelift is a process where your own blood is drawn, treated, combined with a filler and then reintroduced to targeted areas via injection. This procedure is called Platelet Rich Plasma (PRP) Therapy, and it can, indeed, revert your skin back to its previous, youthful, glowing appearance.

How Does PRP Work?

Collagen, which is the body’s most plentiful protein, replenishes dead skin cells and provides skin elasticity and strength. As you age, you lose collagen, which is why your skin tends to become loose, stretched, and less supple, just like an overused rubber band that needs an extra twirl around your Saturday morning ponytail to keep it from falling into your eyes while you clean.

Blood contains growth factors called platelets. In Platelet Rich Plasma Therapy (PRP), a vial of blood is drawn from your arm and put through a centrifuge for several minutes. This isolates the plasma and platelets together from the rest of the blood so that they are concentrated and no longer diluted by the rest of the blood.

A special additive spurs the plasma to release their growth factors. It is then thickened with a hyaluronic acid filler. (Hyaluronic acid is a natural gel-like molecule found naturally in the body which provides moisture, hydration, and lubrication) Upon injection to the area that will be treated, increased collagen growth is stimulated, replenishing what was lost over time.

What are the Benefits of PRP in a Vampire Facelift?

Platelets play a key role in the body’s healing and clotting process. When a wound occurs, they’re the first to arrive on the scene. They develop a stickiness and latch on the hurt cells, which in this case is the injection site. They then band together, in essence, ‘joining hands’ with each other to fashion a protective web of sorts, both in and over the wound. This forms a weak wedge or plug to stem the flow of blood.  They then emit chemicals to ‘call’ or attract stem cells over help begin stronger clotting—like radioing someone for backup. The body then begins to develop extra collagen to heal the wound.

In PRP therapy, injecting the site with so many plasma rich platelets that the body already recognizes as its own, dupes it into thinking that, since there are so many platelets at the ‘accident site’ the damage must be excessive. It assumes extra collagen is needed and produces it. That additional collagen, along with added filler used in the Vampire Facelift procedure, pushes out the hollows and wrinkles, smooths out the skin, and continues to produce healthy skin for months to come. For women between the ages of 25 to 70, this results in:

• Almost immediate younger looking, firm skin with renewed elasticity
• Continuing improvement in appearance over time as growth cells and blood supply continue to be stimulated
• Diminishment of crow’s feet and other fine lines around the eyes, mouth lips and forehead
• Healthier looking color and texture
• Hydrating replenishment of papery looking, sun-damaged and loose skin
• Fuller, more taut skin around the neck
• Less visible scarring
• Improvements to hollowed or darkly circled eyes
• Overall improvement lasting for up to a year-even more
• A more radiant, healthy-looking

What’s the Difference Between a Vampire Facelift and a Vampire Facial?

You may not need a full Vampire Facelift if you only have moderately visible lines that you want to correct. In that case, a Vampire Facial, which only uses the platelet-rich plasma without any added soft tissue dermal filler may adequately take care of the problem.

How Can Cherokee Women’s Health Specialists Help?

Any injections into the body require skill, knowledge, focus, concentration, and expertise. Only an accredited professional should be consulted to perform such procedures. At our clinic, Dr. Haley and Litrel are doubly accredited urogynecologists. They hold degrees in OB-GYN and Female Pelvic Medicine and Reconstructive Surgery (FPMRS). Dr. Haley has over a decade of experience in injectables, having obtained his certification in the field in 2007. Our physicians’ intense combined training makes them a superb choice for all your women’s health and cosmetic needs. They are committed to doing their utmost to ensure the health, confidence, well-being, and beauty of their patients, one woman at a time.

For a free consultation or to schedule an appointment for a Vampire Facelift, contact our office.

With the soaring popularity of fillers, cosmetic surgeons have been inundated with questions, including how long the effects last, and who can safely receive the injections. At Cherokee Women’s Health Specialists, these and other queries come up on a daily basis, and we’re more than happy to take the time to answer them, both here and during your free consultation.

What Causes Skin Volume Loss?

We all have a substance called subcutaneous fat. It is directly under our skin, separating it from muscle. Sometimes, we spend a lifetime trying to get rid of it, because it’s what makes our tummies, buttocks thighs and other places bulge undesirably. However, among other important functions, it serves the purpose of giving our outer layer of skin volume, smoothness and contour.

As we age, this fat diminishes, most noticeably in areas like the face, neck, and shoulders. The backs of hands and feet can be affected too. This decrease brings the muscles visibly closer to the surface. Continued use of the muscles, now without the buffer of fat, causes droopiness and sagging. Combined with the additional loss of collagen, which contributes to the skin’s elasticity, the formation of wrinkles, creases, folds, and hollows begins. This results in a drawn and tired facial appearance.

What are Fillers? 

A cosmetic filler is an injectable, FDA- approved substance consisting of soft tissue. It is designed to take the place of the reduced subcutaneous fat. Skin puckers and grooves normally occur due to natural aging, sun damage, and repetitious facial expressions such as laughing, squinting, concentrating and grimacing.

Fillers restore plumpness and lost fullness to these facial furrows. They smooth out areas around the eyes, nose, mouth, cheeks, and chin where laugh lines, crow’s feet, and other wrinkly or papery looking skin typically form. They can also be used to refine facial flaws and irregularities including scarring from acne or minor injuries.

Fillers can also improve the look of the hands, décolletage, and earlobes where bones might protrude, or where skin may have a deflated appearance. They can even provide cushioning relief to regions of the feet exposed to chafing and discomfort from footwear. The entire procedure is similar to reinflating a softened beach ball to make it firm, contoured, and smooth again.

What are Fillers Made of, and Are They Safe?

Because of strict guidelines set forth by the FDA, and the conscientiousness and surgical skill of qualified, accredited physicians like those at Cherokee Women’s Health Specialtists, fillers today are safer than ever.

In the past, fillers consisted of animal-based collagen. This collagen caused allergic reactions in the recipients. Today, synthetic fillers are made of hyaluronic acid (HA) which is modified and bacterially produced. Hyaluronic acid is found naturally in the body. It is a gelatinous molecule that works to keep your joints and skin lubricated-in essence, oil for the body. As you age, your body produces less of this substance, depriving your skin of moisture and causing it to become dry and wrinkled, the same way lettuce becomes limp if it’s not sprayed regularly in a grocery store. Because hyaluronic acid is not alien to the body, there is less chance of any unpleasant reaction.

How Long do the Results of Fillers Last?

It is impossible to pinpoint exactly how long the aesthetic benefits of any dermal filler can last. Longevity depends entirely on a myriad of factors and cannot be predicted or guaranteed, but the norm is 2 months to one year. Variables that can affect duration include:

• The area treated: The more actively the muscles are used in the treatment, (i.e. mouth versus cheeks), the shorter the effectiveness of the product
• The amount and type of filler used: Each brand has different active ingredients which impact the product’s longevity.
• Serum thickness: Thicker serum usually extends the filler’s
• Injection technique: Fillers require specific methods of injection, (‘linear threading’, ‘fanning’, ‘serial puncture’, ‘cross hatch’ etc.), all of which our professionals are qualified to perform. Based on the necessary process, each syringe perforation may use a different amount of filler, thus affecting duration.
• Body metabolism: Today’s fillers, especially those consisting of naturally occurring hyaluronic acid, are absorbed, go through the waste process and are eliminated the same way food is. Therefore, the duration of a filler’s effectiveness is also based on your metabolic rate.
• Lifestyle: Active lifestyle and excessive exercise can cause the body to break down fillers more quickly due to increased metabolic rate. More frequent treatments may be required to maintain results.
• Sun exposure: Sun accelerates the aging process which, in turn, necessitates more treatments.
• Body chemistry: Each individual undergoing the procedure will process the filler differently based on such things as genetics, use of medication, diet, etc.

Who is a Good Candidate for Dermal Fillers?

Cherokee Women’s Health Specialists use fillers made by Juvederm. We rigidly adhere to all maker’s product guidelines. Our clientele falls into their recommended category of women aged 25 to 75. Additionally, the best candidates should be:

• Non-smokers
• Women who are diligent in practicing impeccable skin care
• Women who do not expect their appearance to be so dramatically changed that they become unrecognizable.
• Women whose general health is good and don’t suffer from any chronic or debilitating illnesses or immune conditions that may be compromised by receiving dermal filler injections.
• Women who are not pregnant, breastfeeding or planning either while receiving filler treatments. (No conclusive studies exist regarding filler impact on pregnancy or breast milk)
• Women who have no evident allergies to any filler ingredients.
• Women without severe scarring or pigmentation
• Women who have not recently had other facial treatments or plan to do so while using fillers
• Women who do not regularly take medication that may cause problems when used in conjunction with cosmetic fillers.

Why Should I Go to Cherokee Women’s Health Specialists for My Filler Procedure?

In one word–expertise! Fillers replace many of the highly-invasive rejuvenating plastic surgeries women had to undergo in the past to maintain a youthful appearance.

Because treatments are quick, virtually painless and need no convalescence, many inexperienced non-professionals are performing them with limited training in correct dilution, application, or anatomical knowledge. Women have been left with irreversible damage after being lured by the promise of dramatic, unrealistic results that come with a preposterously low price tag. In many cases, women have attempted the process themselves, using rogue, imitation products. The outcomes were disastrous-blindness, scarring, infection,-even permanent disfigurement, just to name a few.

At Cherokee Women’s Health, our practitioners possess the highest qualifications and are abreast of the most up-to-date cosmetic surgery developments available. Drs. Litrel and Haley are both board- certified urogynecologists with double accreditation in OB-GYN and Female Pelvic Medicine and Reconstructive Surgery (FPMRS). The latter degree sanctions us to minister to all of your uniquely feminine requirements. Our proficiency in rejuvenation and reconstructive procedures tops the list of the many broad-based services we provide. Moreover, since 2007, Dr. Haley has been certified in injectables, giving him over a decade of skill, practice, and experience in this field.

The aging process does not have to be a visually undesirable one. Today’s facial cosmetic techniques can easily and safely match your outer appearance to reflect your inner youth. You can trust us to help you attain that goal with the safest and most meticulous precision, expertise, care, and commitment to your safety and well-being.

Call to schedule a free consultation with one of our double-board certified physicians at 770.720.7733.

By James Haley, MD, FACOG, FPMRS 

The fountain of youth may be just around the corner. 

Actually, the truth is that there have been tremendous advancements in non-invasive cosmetic procedures. All-natural dermal fillers have been gaining in popularity the more their incredible benefits have become apparent. These products are made from natural elements already found in the skin, elements which happen to decline with age. Using these products as fillers produces a lasting positive benefit – simulating skin to rejuvenate itself without having to go through the pain and long recovery of plastic surgery. 

The Downfall of Traditional Facelifts 

A traditional facelift requires a substantial investment of money and involves a long recovery period, usually about 6 weeks. There are risks associated with anesthesia and undergoing surgery. We have all seen the pictures of celebrity facelifts gone bad, and you always run the risk of becoming disfigured or scarred in some way. When done properly, a facelift can have great results, but there is considerable pain and recovery time. 

Dermal fillers offer an obvious advantage over surgery in both the pain and recovery aspects, as well as the procedure itself only taking a short time. 

The Benefits of Dermal Fillers 

Natural dermal fillers are an excellent way to achieve rejuvenated youthful appearance – with virtually no pain and no downtime. In the aging process, skin loses elasticity and shape. The face begins to sag. Dermal fillers such as Juvederm are injectable gels made from hyaluronic acid, a hydrating substance that your body produces naturally. Injecting different types of these fillers under the skin immediately adds volume and reduces wrinkles and deep folds. 

Different types of fillers are formulated for each distinct purpose. Juvederm “Voluma” adds volume and contour to the cheeks, reducing lines and giving the face an overall lift.  Juvederm “Ultra” adds volume to the lips and fills in the lines around the mouth. Juvederm “Ultra Plus” fills deep lines such as the nasolabial folds or marionette lines (the downturned lines from the corner of your mouth to the jawline). The results are not only instant, but can be quite dramatic.  

Your face is the most visible part of you, and dermal fillers can help give you a more youthful and refreshed look.  Schedule a free consultation with experienced double board-certified physicians to achieve the health and beauty you desire – inside and out! Call us at 770.720.7733

This article was originally featured in the February 2018 issue of Townelaker Magazine. To view an online version, please click here. 

By James Haley, MD, FACOG, FPMRS 

Dr. Haley

Traditionally, women turned to the youth-restoring practice of Botox treatments beginning in their forties. More recently, however, the trend has shifted toward a younger age. This is done to not only smooth out wrinkles and flaccid skin, but to actually prevent the slackening process from happening at all.  

Technically, there is no magic age to begin treatment – it varies from person to person. A good rule of thumb is to look in the mirror and smile, frown, and then relax the face. If significant lines and wrinkles still remain while your face is relaxed, you may want to consider preventative Botox treatments. You may notice this occurring at any point between the ages of 25 and 35.  

The Benefits of Early Botox Treatments 

When you begin early Botox administration, the collagen and elasticity breakdown that naturally occurs over the years is inhibited. Muscles that would ordinarily enable wrinkles and lines to form are literally “held still” in a relaxed state. Botox no longer allows these muscles to over-contract in everyday frowns or squints, leaving your skin smooth and taut. Continued treatment allows you to retain a youthful appearance indefinitely – which in turn is great for your self-image!  

Trust Women’s Health Specialists   

To meet the high demand for Botox, numerous physicians and spas offer Botox injections. Though it is a fairly simple process with little risk, choosing the wrong provider occasionally results in negative effects, such as droopy eye or nerve damage. It is important that you locate an experienced, trained physician.  

As OB-GYN’s who care for women through all the stages of their lives, at Cherokee Women’s Health Specialists we are sympathetic to the fact that women want their outward physical appearance to mirror their inward physical health. Reconstructive surgery, and rejuvenation and cosmetic care are a natural extension of our services as women’s health care providers. Drs. Litrel, Gandhi and myself are doubly accredited OB/GYN’s and Urogynecologists with board certification in both Female Pelvic Medicine and Reconstructive Surgery (FPMRS) and OB/GYN. This unusual qualification allows us to expertly treat the unique health problems of women – including the “finishing touches” of cosmetic procedures for a youthful appearance. Thus, Botox and injectables have been part of my services for my patients since 2007. 

Beginning with an in-depth consultation, we can administer Botox so that you can enjoy its rejuvenating benefits.  Skilled hands can keep your outer appearance looking every bit as youthful as the age you feel in your heart. 

Call our office at 770.720.7733 to schedule a free consultation.  

This article was originally featured in the January 2018 issue of Townelaker magazine. To view an online version, click here. 

Traditionally, women started turning to the youth-restoring practice of Botox treatments in their mid-thirties or forties. More recently, however, the trend has shifted towards a much younger age-not only to smooth out wrinkles and flaccid skin, but to prematurely prevent the slackening process from happening at all.

Experts agree that starting Botox treatments at a younger age is beneficial to prevent lines and wrinkles from ever occurring. But at what age should Botox treatments begin?

Benefits of Early Botox Treatments

Technically there is no magic age to begin treatment, and it generally varies from person to person. A good rule of thumb is to look in the mirror and smile, frown, and then relax the face. If lines and wrinkles remain while the face is still relaxed, it may be time to consider preventative Botox treatments. Most will notice this occurring between the ages of 25 and 35.

When you begin early Botox administration, the collagen and elasticity breakdown that naturally occurs over the years is inhibited. Muscles that would ordinarily be enabling wrinkles, folds, and lines to form over time are literally frozen into a relaxed state. Botox no longer allows these muscles to contract as they attempt to comply with everyday expressions such as frowns, squints, or grimaces, thus leaving skin smooth and taut. Continued treatment allows you to retain a youthful appearance indefinitely, which in turn raises confidence and boosts self-image.

Trust Your Women’s Health Specialists 

In order to meet the high demand for Botox at a younger age, there are numerous physicians and “medical spas” that offer Botox injections. Though it is a fairly simple and quick process with little risk, choosing the wrong provider could result in negative effects such as penetration or damage to untargeted muscles, unnecessary bruising, excessive redness, headache, nausea, and drooping or tearing in the sensitive eye area. As well, improper application can cause symmetrical imbalance, or even have no desired effect whatsoever. It is important, therefore, that you opt for an experienced, trained medical specialist.

At Cherokee Women’s Health Specialists, we hold and maintain our outstanding reputation in women’s health, reconstructive surgery, and rejuvenation and cosmetic care by putting you and your individual needs first. Drs. Litrel, Haley, and Gandhi are doubly accredited OB/GYN’s and Urogynecologists holding degrees in both Female Pelvic Medicine and Reconstructive Surgery (FPMRS) and OB/GYN. This enviable certification qualifies them to treat all of your personal, unique feminine problems, including any cosmetic requirements such as Botox injections. Dr. James Haley has had experience and certification in Botox and Injectables since 2007.

Voted ‘Best OB-GYN in Towne Lake, Canton and Woodstock’, we strive to continue meeting the highest standards that earned us this recognition.

At Your Botox Consultation

Beginning with an in-depth consultation, we can administer Botox in a safe, long-lasting manner that adheres to all FDA guidelines, including precise serum dilution. Your process will take place in a pristine environment with focused attention to the muscle location necessary for effective and successful results.

There is no finite age when Botox becomes ineffective or must be discontinued. Women well into their eighties are enjoying its aesthetic rejuvenating benefits. You can too, by letting us do our skilled part in keeping your outer appearance looking every bit as youthful as the age you feel in your heart.

Call our office at (770) 721-6060 to schedule a free consultation.

Is liposuction right for you? Certain requirements must be met in order to ascertain whether this surgery will be a potentially successful one for you. An appointment for a preliminary consultation with your physician should always be made so that you fully understand the benefits, risks, and exactly what the procedure entails. It is necessary to be completely honest and open with regards to the expectations you may have and the results you expect.

Many women assume that this procedure is the answer to all their prayers – that it will magically give them the firm, svelte body they’ve always dreamed of having. This is not the case.

Liposuction is not a quick fix for weight loss. Nor does it miraculously get rid of excessive cellulite or stretch marks. The purpose of liposuction is to remove resistant bundles of fat that stubbornly refuse to respond to regular diet and exercise, especially after you have reached and maintained a healthy weight. If you are in good enough physical condition to undergo this surgery, only strong determination, good eating habits and regular exercise will keep the weight from returning. Liposuction cannot do that for you. Its results are only permanent if your weight remains stable.

It needs to be mentioned that liposuction only removes what is referred to as ‘adipose tissue’. This is fatty connective tissue that consists of those lingering fat cells you want to banish from your body. That is liposuction’s sole purpose. It does not remove excess skin nor does it tighten or repair anything internally or externally the way a tummy tuck or breast lift might, though it is on occasion, used to extricate small, leftover fat deposits during a tummy tuck procedure. Generally, it simply removes bulges, lumps, and bumps via suction to give the trouble spots in question a more sculpted, smoother appearance. Liposuction is, however, often performed simultaneously with other cosmetic procedures like the ones mentioned.

Additionally, positive change will not show overnight. It can take up to three months to see the benefits, and to see optimum results, all precautionary instructions you are instructed to follow regarding your aftercare must be adhered to. This includes wearing a pressure garment for the specified amount of time. Some discomfort and swelling should be expected, along with leakage at the incision site for several days. The extra effort on your part should, in time, bring about a more pleasing appearance.

Who is an Ideal Candidate for Liposuction?

• Women who are within 15% to 30% of their ideal body weight according to body mass index (BMI) calculations.

• Women who have fat deposits confined in their necks, thighs, abdomens, arms, back and other areas that have proven to be unresponsive or genetically resistant to diet and exercise.

• Women in good physical health who have no critical illness or chronic condition that may hamper healing.

• Non-smokers.

• Women who no longer plan to get pregnant.

• Women with a positive mental and emotional outlook.

• Women with a strong determination to maintain their current health and weight long term.

• Women of any age who presently have strong, firm skin elasticity.

Are There Ever any Medical Reasons to Perform Liposuction?

Yes. Liposuction is usually considered an elective surgery, but there are exceptions where it is warranted for medical reasons. These include:

• Profuse armpit perspiration (axillary hyperhidrosis)

• Fatty benign tumors (lipomas)

• Fat metabolism problems (lipodystrophy)

• Enlargement of the dorsoscervical pads (buffalo hump) which can be caused by adrenal disease or certain medications such as anti-HIV drugs or steroids.

What Conditions or Issues Might Disqualify a Woman From Receiving Liposuction?

Since liposuction is a surgical procedure, certain medical or physical conditions may prove dangerous or even fatal depending on their severity. Sometimes general anesthesia is used, usually when the operation is coupled with another cosmetic procedure. These problems, depending on their severity, could prevent patients from withstanding the procedure safely. Therefore, the following disadvantages may preclude them from being prime subjects:

• Women who suffer from depression: Depression can be a possible after-effect of any surgery, including liposuction. Any pre-operative depression can worsen the condition. Furthermore, certain antidepressant or anti-anxiety medications can be extremely dangerous when combined with anesthesia.

• Significantly overweight or obese women: Typically, skin elasticity is lost with the stretching that occurs with considerable weight loss, making it less likely that the surgery will give the smooth, firm, desired appearance.

• Women who have been diagnosed with scarring/collagen or connective skin diseases such as collagen vascular disease, etc.

• Women with extreme stretch marks.

• Women with acne who have used Accutane up to 6 months prior to surgery.

• Women suffering from Lupus erythematous, endocrine problems, lung or heart disease, high blood pressure (hypertension), diabetes, vascular and circulation problems, healing complications, and blood clotting disorders.

Can I Continue to Take My Daily Medications?

It is mandatory that your doctor is aware of every single medication, herb, and supplement you take regularly or even occasionally. This includes all recreational drugs and alcohol. They are not there to judge, only to take every precaution to ensure absolute safety before, during, and after your procedure. Many of the above may have a detrimental effect on you physically and emotionally. You may be required to discontinue some of the products you are taking, and only your specialist knows how to advise you in this matter.

Liposuction has evolved considerably since its introduction into the world of cosmetic surgery. Though it is much less invasive than ever before, it is still surgery and should only be performed by a qualified, board-certified specialist experienced in the procedure.

To schedule a confidential consultation or for more information, please call our private number at 770-721-6060.

Liposuction may be right for you if you’ve been struggling with excess weight in certain areas that just won’t budge, even after trying every exercise and diet known to man.

What is Liposuction?

Liposuction is a procedure that removes fatty deposits from the body using a suction method. The process is quite simple to understand. A thin tube called a cannula is inserted under the skin into a small incision near that troublesome mass you want gone – and just like that vacuum you use at home to inhale the dust bunny from under your couch, that cannula sucks out the fat.

What is the Purpose of Liposuction?

Many women are under the false assumption that liposuction is a quick fix for weight loss and can eliminate cellulite or stretch marks. This is not the case at all, and the procedure is never recommended for these reasons. In fact, even the most intense liposuction procedures only result in a difference of under five pounds, which is hardly enough to warrant undergoing any surgery.

Liposuction is recommended as a final effort to correct, reshape and sculpt those trouble spots that have been resistant to diet or exercise. Stubborn fat deposits tend to become squatters in the abdomen, buttocks, outer thighs, face, neck, hips, legs, upper arms, back, and waist. Liposuction eliminates these clusters, leaving your skin with a smoother, shapelier appearance.

What are the Benefits?

Your self-confidence and mental outlook are just as important as your physical health. Liposuction can offer you the opportunity to walk into a room poised and self-assured, instead of agonizing over whether anyone notices that unwanted bulge you’re trying to conceal with tight, torturous undergarments. Self-esteem rises with positive self-body image, and though beauty is, indeed, only skin deep, it’s your skin and only you can decide when you’re comfortable in it.

Is it Painful?

New techniques have made liposuction much safer, less painful, faster and easier. Depending on the particular process being used, and the amount of fat to be removed, you may only need local anesthesia and a sedative to keep you calm throughout the process. If larger amounts need to be extracted, or if you are undergoing additional surgery such as a tummy tuck (abdominoplasty), facelift, breast reduction or other cosmetic surgery, general anesthesia may be required. If necessary, your doctor will prescribe pain medication.

What is the Recovery Time?

Typically, depending on the amount of fat removed, any major discomfort eases within 2 to 4 days and normal activity can be resumed within a few days. Swelling and bruising at the entry site can be expected to last 7 to 10 days and you may be required to wear a compression garment for a specified amount of time. Some fluid drainage is to be expected and an antibiotic might be prescribed before and after to ward off infection. You may not see the complete effects for quite some time, especially if a significant amount of fat was drawn out. You will, of course, be advised about aftercare and what to watch out for, such as swelling, numbness etc., before being discharged, either from the clinic or hospital where your process takes place. In many cases, you will be allowed to leave within a few hours following your procedure.

As with any surgery, there are always risks, and liposuction is indeed surgery. Therefore, it should always be performed by an experienced, board-certified specialist who will brief you thoroughly and take the time to answer any and all questions you may have.

For more information or for a confidential consultation, please call our private number at 770-721-6060.