Things to do in Knoxville TN

The beautiful Knoxville TN area has long been one of the most popular tourist destinations in the southeastern United States. Located in the eastern have of the state, near the Great Smokey Mountains, Knoxville offers a wide variety of exciting and interesting things to do for everyone. It doesn’t matter if you are a sports fan, a brew fan, or a history buff, this town has something for you. A picturesque town filled with old south charm combined with a bustling and energetic modern city, Knoxville is a must visit destination. Let’s take a look at some of the cool things that you can do while in the Knoxville and the greater Knox County area.

WORLDS FAIR PARK
The worlds Fair of Knoxville, held in 1982, was without a doubt one of the most important events to occur in the state in modern times. The exposition received over 11 million visitors during its run which closed on October 11, 1982. When the Worlds Fair closed, however, unlike locations of previous worlds fairs, the city didn’t let the grounds of the exposition fall into ruin or be redeveloped into something else. Instead, the city embraced the park and has turned it into a jewel that is beloved by all citizens of the area and visited every year by thousands. The park includes the Tennessee Amphitheater, the historic Volunteer Landing, the Festival Lawn, and the massive performance lawn. There is always something happening at or near the Worlds Fair Park. Check out the website for more information. Hours and any admission vary by event, but the park is open to the public daily.

THE SUNSPHERE
Constructed for the Worlds Fair, the Sunsphere was the fairs official symbol. There was an observation deck as well as a full-service restaurant. It is one of only two structures that remain from the fair, the Tennessee Amphitheater being the other. IN 2005 the mayor of Knoxville announced that the sphere and the amphitheater would be renovated for public use. In 2007 the observation deck reopened to the public and private businesses took up residence in spaces on the 5th thru 8th level. There is no charge to visit the observation deck which is usually open 9 am to 10 pm daily. More information can be found on the Sunsphere page of the Worlds Fair Park website.

KNOX BREW TOURS

Knox Brew Tours offers tours to all of the major breweries in the greater Knoxville TN area. There are also exclusive brewpub tours. All tours are conducted by professional guides and are transported on comfortable mini charter busses. Each tour includes four breweries. The brewpub tours include three brewpubs. Tours take place on Thursday, Friday, and Saturday at set times. Tours for groups and on days Sun-Wed can be booked privately. Tours include three 4oz pours per brewery for a total of 12 beer tastings per tour. Tours average $49 per person per tour. Check out the website for Knox Brew Tours for more information.

These are just a few of the many great things to do while in the greater Knoxville TN area. Knoxville is a wonderful place to visit, once you see the charm, history, and excitement of this great old American city, you will for sure want to visit again and again.

Protect yourself and your love-ones only chose a board certified plastic surgeon for cosmetic procedures

If you have coronary heart disease and need open heart surgery to bypass clogged vessels would you chose a family practice doctor or an ER physician to perform the surgery? No! Likewise why do some people who desire cosmetic surgery go to a non-plastic surgeon like the ones mentioned above for their cosmetic needs? Seems strange don’t you think? Actually it is flawed reasoning and it could cost you your life. In fact, recently in Miami Florida a surgery center which allowed a family medicine trained doctor without any surgery training or in depth knowledge of critical surgical anatomy to perform a Brazilian Buttock lift. Tragically, the patient died of cardiac arrest most likely as a result from injecting large volumes of fat directly into large veins within the gluteal muscle resulting in fat emboli to heart and lungs. Plastic surgeons with years of surgical training supported with constant continuing medical education supported by the American Society of Aesthetic Plastic Surgeons and The American Society of Plastic Surgeons would be far less likely to make that same mistake. Why take that chance when life is too precious and ultimately irreplaceable. Saving a few dollars by using a fringe doctor could ultimately kill you and, needless to say, not worth it. Aesthetic plastic surgical procedures can provide enhanced self-esteem and permanently alter the form and function of undesired areas of the face and body. These procedures are real surgeries which are technically demanding and can result in unwanted complications even in the best of hands. As is the case in any other surgical field, expertise coupled with a large volume of clinical experience results in best outcomes.

Unfortunately, economic driving forces such as reduced physician reimbursement, health insurance monopolies, and greed for maximizing profits have enticed practitioners to leave their comfort zones to pursue procedural based fee-for-service businesses outside of insurance contracts. Other contributing factors include the driving force of equipment manufacturers encouraging sales of their surgical devises along with weekend educational courses to stimulate sales. Many of these individuals have limited training, almost no clinical experience, and zero credentials in the way of professional society’s support of education and analysis of clinical outcomes for a given procedure. In fact, The American Society of Aesthetic Plastic Surgeons leaped into action to delve into cases of operative deaths related to the ever increasing popular procedure of the Brazilian Buttock Lift. Such cases within the United States and abroad were analyzed using data from operative records, interviews with surgeons and staff as well as autopsies to define the problem and make recommendations to avoid unwanted deaths. Unfortunately most of the deaths occur under the care of non-plastic surgeons who probably don’t even know what they don’t know. This past spring the annual national meeting of ASAPS in San Diego dedicated time to brief the membership on important steps to avoid unwanted outcomes. In the right hands, with experience and excellent surgical training, these procedures can provide amazing results that fulfill the aesthetic goals of women seeking a more pleasing shape to the buttock area while enhancing unwanted contours elsewhere on the body. The bottom line: liposuction and fat grafting are true surgeries not to be performed in back rooms of clinician’s offices or unregulated outpatient surgical centers where peer review and outcome analysis is absent and best practice guidelines are intentionally ignored.

I spent almost a decade and a half in training specifically to provide exclusively high quality surgical care for my aesthetic plastic surgery patients. Together with my plastic surgery colleagues, I am passionate about providing excellent outcomes for our patients with minimal complications and I find it offensive when untrained people try to enter the same arena to provide services simply to make extra money. This is not just business to me its personal because we in the field of plastic surgery have dedicated our lives to this cause.

Brows that WOW – Microblading

On the cutting edge of aesthetic services, The Lucas Center is now offering Microblading.  Microblading is a semi-permanent eyebrow tattoo for those who wish to create or enhance their natural eyebrows. This procedure allows you to fill and redefine the eyebrows creating results with a natural appearance. Unlike permanent cosmetics, Microblading is performed by manually depositing pigment into the upper layer of the dermis. These micro-strokes mimic the appearance of real hair, lasting up to 2 years.

Microblading is performed in two sessions 4-6 weeks apart to achieve a full eyebrow appearance. A touchup every year is recommended to keep eyebrows looking fresh and crisp.  Eyebrow shape and size are customized to individual client preference.  Color options are available for desired aesthetic results. 

This procedure is ideal for those who want a natural look without daily maintenance.  For the comfort of our clients at The Lucas Center, we offer a local anesthetic administered by our RN/Aesthetician at no additional charge.

Call The Lucas Center to schedule your procedure today!

Not all aging necks and aesthetic plastic surgeons are the same.

Human faces like snowflakes are all very unique and present unique challenges for the aesthetic plastic surgeon. It is vital for a surgeon to perform an in-depth three dimensional facial analysis prior to considering a customized treatment plan for the patient. Unfortunately many prospective patients get starry eyed with marketing by companies offering new technologies for aging necks and faces. Such technologies include cryolipolysis (CoolSculpting), radiofrequency skin tightening (Ulthera), fat dissolving injections (Kybella), LASERS, and barb suture thread lifts of the face. Confusion exits among patients as well as surgeons as many varied surgical techniques are now available to provide a refreshed rejuvenated face and neck.

So, which one is right? The answer can be quite a challenge for prospective patients to discern. The bottom line is the variables of surgical techniques utilized by the surgeon. But most importantly – the technologies deployed are always less important compared to the individual surgeon’s skill who is performing these procedures. Many roads can lead to Rome, just as many described surgical procedures can produce outstanding results – a comprehensive assessment of the face and an understanding of the three dimensional anatomy of facial bones, the underlying muscles and their balance of activity levels, the deposition of fat in deep pockets and subcutaneous layers, and finally the volume and quality of the overlying skin must be viewed as a cohesive unit for optimal results. Skilled artistic surgeons must first visualize in 3-D the current anatomy as well as understand how to balance all of these components to produce a collective harmony of the face during a rejuvenation process.

The individual techniques to address all these levels of treatment are less important than being able to aesthetically analyze and bring forth an organized approach to get to the final product. The artist who is composing a figure out of stone must first see the final product within the raw material. This vision is significantly more important than the discussions of how to subtract the excess stone, as each artist has his own unique method to achieve art. This is counter to the current evidence-based-practices within surgery and medicine today where uniformity of techniques and processes are mandated for best practice outcomes. Laparoscopic gallbladder removal has become quite standardized with limited deviations allowed to control outcomes and cost. However, this cannot be extrapolated to aesthetic facial rejuvenation. The aesthetic eye of the surgeon is the final arbiter of the quality of the outcome as long as the individual surgeon executes his procedure to the highest level of care.

Your face is as important of a collective of your individuality as any other part of your body. Therefore, it is tantamount for a prospective patient to choose wisely who will perform their facial rejuvenation from non-invasive procedures such as neurotoxins and filler agents all the way to surgical procedures. It is not a simple commodity such as purchasing the same car at various dealerships. The patient is choosing artistry, knowledge, and skill of the surgeon not the name of a product used, technology, or named surgical procedure. These are inconsequential to the outcomes of success. Interview your surgeon, ask to speak to their patients, view their repertoire of before and after pictures to assess judgement and a discerning aesthetic eye. Skill in marketing and name recognition does not always parallel quality of results. Choose your artist well for happy, best results in aesthetic procedures.

At the Lucas Center, Plastic Surgery we take great personal pride and dedication to providing patients with the best possible outcomes of both non-invasive and surgical rejuvenation of the brows, eyes, nose, face and neck. Contact us at either thelucascenter.com or 865-218-6210.

Breast enhancement with implants and fat grafting utilizing lipofilling technique

Style and personal preferences continue to evolve in breast enhancement trends. Women are requesting a more natural, proportionate breast enhancement compared to the 1990’s Bay Watch appearance. This reflects both style changes and is better aligned with outcome data by both The American Society of Plastic Surgery and the American Society of Aesthetic Plastic Surgery, which denotes smaller revision rates for patients who chose implants offered to them by surgeons who base the choices from a tissue based diagnostic analysis. Women today want long term results which will provide “perky” uplifted breasts proportionate with their frame and will not bottom out overtime from excessively large implants. This lends itself to other trends seen in popular magazines such as the “free the nipple campaign,” and evening gowns with side breast exposure which looks much better with a breast well confined to the anterior chest wall. This profile provides an attractive lateral breast silhouette compared to an overly protruding lateral bulging breast from excessive breast volume or excessive implant size.

I have incorporated an amalgamation of several analyses from leading authors for determining the best implant options for my patients. However, I strongly focus not only on the soft tissue but the underlying skeleton as well. Just as an architect or a civil engineer has to factor the underlying topography of a building site so should a plastic surgeon in the final treatment plan for their patients. The shape and width of the sternum (breast bone) and the shape and slope of the underlying rib cage as it merges with the axillary region has significant impact on how successful a breast enhancement will appear. Imagine if you would a wide breast bone separating the two breast will not allow a tight cleavage appearance no matter how large of an implant is placed. Rapidly sloping rib cages from the sternum to the axilla will result in the overlying breast laying divergent from one another and the larger the enhancement with an implant the more divergent the nipples will become. Also long torsos often times will result in a long distance from the breast fold to the collar bone giving an appearance of a low set breasts. And the situation of a narrow chest wall with a long torso often times, in my opinion, mandates a shaped implant (taller in height than in width) with a highly cohesive anatomic gel compared to a responsive gel to provide an appearance that the breast begins higher on the chest wall. In my clinical experience, roughly forty percent of all the women who seek breast augmentations either have a skeletal configuration issue or a breast soft tissue issue such as a constricted breast deformity that may result in less than satisfactory results with an implant alone. This is why a very thorough physical exam combined with the patient being able to see themselves in a three dimensional imaging system (VECTRA) will allow them to understand why they cannot achieve a result that their best friend may have with a given implant due to individual anatomic variations.

Why Fat Grafting?

The evolution of large volume fat grafting with the expanded volume lipofilling technique to the breasts has been a paradigm shift in how I deliver care to my patients. Fat grafting has proven to be an integral component of an augmentation procedure with implants by helping to overcome some of the anatomic limitations stated above that women may exhibit which can greatly diminish the outcome of these procedures. It has elevated my results additionally by softening the outline of the implants superiorly and helping to avoid the pleating appearance which may occur with even silicone gel placed in the sub-glandular plain. Certainly a controversial topic in any plastic surgery forum on breast augmentation is which anatomic plain is superior for placement of implants. However, my current view, as well as many other highly respected plastic surgeons is: if it is at all possible avoid the downsides of the muscle by placing the implant under the gland. This can reduce animation deformities and the continuous strain of the muscle contracting overtop of the implant increasing the likelihood of the devise from being displaced inferior-laterally overtime. Also, for the constricted breast deformity where the anatomic fold is too high and the lower pole of the breast is tight with less breast volume present, the plan of action is to score the breast tissue underneath and lower the fold to allow the limited breast volume to unfold around the lower pole of the implant to avoid a double bubble effect. Unquestionably, the use of added fat volume to fill this space to further cover the lower implant will, at the same time, result in superior outcomes. I also think that the soft tissue/ implant ratio, if unfavorable, may also lead to an increase risk of capsule contracture outside of the normal biofilm/inflammatory mediated model. I also utilize fat grafting in many of my mastopexies (breast lifts) when performed with or without an implant or in the event that some women wish to permanently remove their implants and wish a breast lift only. Fat grafting can be a wonderful means of adding upper pole volume without the implant. Some women choose to enhance their breasts with fat grafting alone. I first discuss with them that, in my opinion, a combination technique is best but the fat grafting technique alone can yield a modest increase in cup size. Generally, breast volume is stable at around four months post surgery with around 30-40% of the initial fat grafting volume lost due to lack of vascularization. Unfortunately, the best outcome with this approach is right after surgery with all of the fat grafting present combined with natural swollen tissue.

What is expanded volume lipofilling.

Dr. Sydney Coleman was the first plastic surgeon to strongly pursue fat grafting in many areas of the face, hands, and breast. He initially was viewed as a pariah in the industry but his persistence has led to a wide spread acceptance of the concept of fat grafting. He initially used very small cannulas with limited volume application and placed in many different plains to ensure the fat graft take with a blood supply. Fast forward to today, critical thinkers such as Drs. Simeon Wall and Dan DelVecchio have risen to the needs of large volume fat grafting to the buttock and breast and have created a technique of simultaneously expanding the volume of the recipient site (i.e. breast tissue and overlying skin) while back filling this enlarged space with fat in a very expeditious method utilizing PAL (Power Assisted liposculpting) headpiece with an expanded basket cannula. Essentially, the vibrating headpiece is connected to a hydrostatic pump that moves fat from the harvested reservoir retrograde through the cannula and dispenses the fat in a very laminar pattern similar to shaking tiny mustard seeds from a hand onto the ground. This very much avoids clumping which can lead to fat necrosis nodules. The vibrating motion of the basket cannulas expands the volume of the space thus reducing hydrostatic forces on the newly placed fat cells allowing for a greater volume to be placed without strangling the cells under undo force. Additionally, this process rapidly speeds the placement process compared to pushing single aliquots of fat being injected via a syringe thus reducing expensive operative time for the patient. I generally agree with the technique of fat harvesting into a large canister with fat separation from the aqueous component with decanting methods only for the buttock, but with the breast containing a more limited space particularly with an implant underneath, I prefer to clean the fat and more thoroughly remove the excess aqueous fluid with a single use devise called Revolve by Allergan. Therefore, I can be assured all volume injected is viable fat and not excess fluid as well.

In conclusion, successful and extraordinary results in augmentation mammoplasty can be achieved but requires three dimensional thinking, of not just the breast, but the surrounding skeletal and soft tissues of the chest wall. Implant decisions are not just based on volume alone but on the distribution of volume in various implants and may require a shaped implant to achieve a superior result of a round devise. The use of fat grafting to enhance areas of soft tissue deficiencies surrounding implants or to place volume outside of where an implant cannot be placed such as the decollate can lead to superior results not previously available with implants alone utilizing sculpting techniques with fat. Lastly, the newly acquired techniques of expanded volume lipofilling are creating more efficient and larger successful volumes of fat administered with this methodology.

If you are interested in a thorough three dimensional analysis for an ideal breast enhancement tailored to your specific needs please contact The Lucas Center, Plastic Surgery,Knoxville, Tennessee at thelucascenter.com or 865 218 6210.