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Skin Care 101 with Obagi!

Skin resurfacing, fillers, and chemical peels are just a few of the ways to keep your skin looking its best. Some of our patients who desire a more youthful opt for facial plastic surgery procedures like face and neck lifts, chin augmentations, and midface lifts. Taking proper care of your skin once a procedure is complete can make an enormous difference in maintaining your new and vibrant appearance.

Napa Solano Plastic Surgery is proud to offer our clients premium clinical skincare products from Obagi formulated for a wide variety of skin types, conditions, and purposes.

Obagi! Skin Care Line

Obagi is famous for its Blue Brilliance™ Triple Acid Facial Peel, but the company’s full line of skincare systems and products can help anyone hoping to revitalize, enhance, and maintain beautiful facial skin for life.

Headquartered in Long Beach, CA, Obagi is a specialty pharmaceutical company that offers proprietary skin care systems in the physician-dispensed skin care market. Its clinically proven products are developed for the plastic surgery, dermatology, and related markets and are valued for their ability to minimize:

  • Skin damage
  • Premature aging
  • Sun damage
  • Hyperpigmentation
  • Signs and symptoms of rosacea

Obagi products include night creams, daily care foam cleansers, facial serums, therapeutic moisturizers and lotions, eye creams, and more.

Facial Plastic Surgery For a More Youthful Appearance

For more than 30 years, Obagi has been a leader in scientific innovation, developing scientifically proven, clinical-quality formulations that promote healthier skin and give people more confidence in their appearance.

Because Obagi products contain prescription-strength formulations, you can only purchase the systems through plastic surgeons, physicians, medical spas, and other medical and skincare professionals. We offer the full range of Ogabi products at our Napa Solano Plastic Surgery/Medi Spa locations in Napa, Vacaville, and Sonoma, as well as on our online store.

Napa Solano Plastic Surgery’s skilled and board-certified doctors have been providing plastic surgery care to Northern California patients for nearly 40 years. The safe and welcoming environments at all three of our locations ensure you get the personal attention and quality care you deserve.

Have questions or want to learn more? Our knowledgeable staff can help you choose a skincare regime that’s right for you. To request a consultation or ask a general question, get in touch with us today.


Hair Restoration for Men

[George Costanza is wearing a toupee]

Elaine: YOU’RE BALD!  George: I WAS bald.


By age 50 about 85% of men experience balding. 21% of men have inherited male pattern baldness and begin seeing hair loss before age 21. The distress of loosing one’s hair has been obviated by society’s changing perceptions of male attractiveness. Look at movie stars Bruce Willis, Dwayne Johnson, Jason Stratham; super athletes Michael Jordan, Andre Agassi, Kelly Slater; recording stars Pitbull, Moby, David Daughtry. 

However, many if not most males would prefer to keep their hair. Currently, there’s no cure for male pattern baldnessUntil recently hair systems, (toupees) were the mainstay of “hair restoration.” Medications like finasteride and minoxidil can help some, but not all men keep the hair they have. 

More promising is PRP (platelet-rich plasma) injections, a non-surgical treatment used to reverse early male pattern baldness by stimulating new hair growth where functioning hair follicles remain. PRP, which is rich in growth factors, is harvested from the patient’s own blood. It is a safe well-tolerated treatment with no downtime. Periodic treatments are recommended. The PRP when delivered by micro-needling, a common procedure we do, can enhance the results. 

Today the gold standard for hair restoration is surgical hair transplantation. First performed in the early 1950’s, hair transplants were done using the hair plug technique. The results were quite unnatural and gave hair transplantation a bad name; a reputation which persists in some people’s minds up to the present. In the 1990’s surgeons obtained remarkably improved results using a new technique called Follicular Unit Transplantation (FUT). Though many hair transplant surgeons continue to use FUT, we now have an advanced, minimally invasive method called Follicular Unit Extraction (FUE). 

Simply speaking, Follicular Unit Extraction (FUE) involves the use of “micro-grafts;” which are tiny grafts of skin taken from the back of the scalp each containing only one or two hair follicles. No scars are made in the donor area. Though grafts can be harvested manually, new technology allows graft harvesting to be semi-automated. The results can be very dramatic, and natural. It is the skilled surgeon who determines the best placement and orientation of the grafts to give the most optimal and natural result.

NeoGraft is a semi-automated hair transplant system which facilitates the harvesting of follicles during a Follicular Unit Extraction (FUE) hair transplantation. This is the technology that we at Napa Solano Plastic Surgery use. The automated harvesting system improves the accuracy and speed over the previously used manual extraction instruments. NeoGraft effectively combines advanced technology with the guided precision and artistry of a qualified surgeon.

85-95% of all implanted grafts are successful. Within 2 to 3 weeks, the transplanted hair will fall out, but new growth will occur in a few months. By 6 to 9 months 60% of new hair growth will have occurred. The process is complete at 12 months.

The procedures are done under local anesthesia with mild sedation. Patients find the experience easy and even pleasant. Patients may return to work in two days, and heavy vigorous activity in 3 weeks.

If you think hair translation is an option for you, or someone you know, we at Napa Solano Plastic Surgery would be happy to answer more questions.


Facial Rejuvenation for Men

You’re so vain, you probably think this song is about you. ~ Carly Simon

Is it vanity that is driving increasing numbers of men to seek cosmetic surgery? After all, in the animal world it is the male peacock who sports the vivid tail feathers, the male lion who wears the splendid mane. I’ve seen a steady increase in men requesting facial rejuvenation surgery. I would argue that this drive to “look younger” is due less to vanity and due more to the desire to look refreshed – to look healthier and more vital. Most men accept that aging, and the accompanying changes in appearance are inevitable. Even though it is unfair, in our society men have many advantages, including the ability to avoid the “onus” of aging. In the movie world we see male actors in their 60’s, and even 70’s, playing romantic leads with women 30 years younger!

So while most men can accept looking older, no one in this competitive world wants to look worn out, worn down, less vital. They don’t want to look tired when they aren’t. They want their appearance to reflect the inner energy they feel. It really isn’t vanity. Looking “worn out” isn’t necessarily a characteristic of aging. Genetics plays a role – what we inherited from our parents. The environment plays a role – how one has treated themselves over the years; too much sunlight, smoking, weight gain.

One can inherit the tendency for “bags” under the eyes, drooping skin above the eyes, heavy brows with deep frown and forehead lines. With age we see the accumulation of loose skin and muscle of the neck and lower face. These features alone and in combination can give one that worn and weary look. These features can make us look older than we feel.

Elective cosmetic operations can be done to correct these unwanted features. The operations can be done alone or in combination. When contemplating elective cosmetic surgery, one is expected to be anxious. I spend considerable time with my patients before surgery to put them at ease. Though I reassure patients that the procedures are extremely safe, most patients are more worried that they may end up looking “unnatural,” like Kenny Rogers or Mickey Rourke. They are nervous that they will not look like themselves, that they will have an artificial look. Their fears are not unreasonable. If you Google “Celebrity Cosmetic Surgery,” you’ll see galleries full of scary results.

Giving patients a natural look is an important principle of rejuvenation surgery that I follow. I show prospective patients before and after photos of our patients to reassure them that they will have a natural look. The gentleman in the photo has had rejuvenation surgery of the forehead, face, and neck. He also had a rhinoplasty (nose job.) He goal was to look younger, more relaxed, less intense.

Facial rejuvenation operations done by experienced board certified plastic surgeons are common and safe. Find a surgeon who specializes in facial rejuvenation surgery and ask to see before and after photos of typical patients. The operations are performed in a comfortable outpatient setting usually using sedation and local anesthesia to provide a peaceful anxiety free experience. Recuperation is quick, and pain during recovery is not an issue. Patients are happy.

To see more patient photos visit our website Gallery

The latest in Breast Augmentation

Too big, too small, too droopy, too lopsided, too…

Many women are unhappy with their breasts and there are no shortage of opinions about what they can and should do to improve them.  In breast augmentation, as in most things related to breasts, the internet is awash in information about this plastic surgery.  Some of it good, but much of it misleading and confusing.   Deciding what’s right for you is actually a fairly straightforward process once you know what to consider.  The decisions that need to be made can be grouped into 3 categories which I like to call the three S’s.  Silicone vs. saline, Surgical approach (where the scar is) and Size.  

Silicone:  It used to be that the decision here was silicone vs. saline, but now, it’s more often what type of silicone.  Certainly, some patients still prefer saline, but most patients choose silicone for it’s more natural look and feel.  However, not all silicone implants are alike.  Newer options include silicone gel of different degrees of cohesivity or whether the gel behaves more like a thick liquid or a soft solid, or a “gummy bear”.  The standard gel implant remains the most popular although these have been upgraded over the last 20 years to have better fill, less rippling and more durability.  On the other end of the spectrum are the highly cohesive or “gummy bear” implants.  In these, the gel is a semi-solid such that if you were to cut the shell around the implant, the gel would not flow out.  In the middle are implants that have a thicker gel than the standard implants but are not a semi-solid like the highly cohesive ones. Why does this matter?  Different implants will have different rates of potential leaking, different effects on breast shape and potential for visible rippling.  The best way to make the decision about which implant is right for you is a thorough discussion with your surgeon. 

Surgical approach:

This is how the surgeon makes the implant pocket and where the resulting scar will be.  The two most popular approaches today are through the crease underneath the breast and through the armpit using an endoscope.  Both approaches allow the surgeon to make a pocket of the right size for the implant, typically with minimal scarring.  The other important decision is whether to place the implant above or below the muscle.  This is where the exam is so important as some patients will have a definite advantage with having the implant placed above the muscles while other patients may have a better result with the implant below the muscle.


Perhaps the most important decision of all is what size implant will be selected.  This is a decision that should be made by the patient in close consultation with the surgeon.  The important factors to consider in breast augmentation are what breast size the patient wants and what their chest and breast will allow.   There are 3 ways to approach this decision.  The first entails careful measurements of the breast and chest by the surgeon.  These dimensions will guide the upper and in some cases lower limits of implant size.  A second approach uses implant sizers placed in a bra to give a patient some idea of proportion or how the implants will look relative to their hips and body.  Finally, there are programs that allow 3 dimensional imaging to be done with realistic depictions of what different implant sizes will look like when they are placed in the body.  The ultimate aim of  sizing is to give patients the breast size and proportion that achieves their goals.  As with most decisions in plastic surgery, this is best achieved with clear communication between the patient and their surgeon. 

What is Erbium laser resurfacing?

Erbium laser resurfacing is a highly effective way to dramatically reduce facial wrinkles, but it does have some significant downtime.  As such, some background is helpful to understand who it’s for and why.

Facial wrinkles are an inevitable side effect of aging and many treatments are available to reduce wrinkles including botox, dermal fillers and surgery.  For certain types of facial wrinkles, these treatments fall short of achieving a significant and lasting improvement.   Examples of such wrinkles would include vertical “smoker’s lines” of the upper and lower lips, criss-cross lines of the cheeks, crepey skin of the eyelids and cobble stone skin texture around the mouth.  While some of these types of wrinkles may be improved to some degree by dermal fillers, many people have wrinkles that are too widespread or that don’t respond well to injectable treatments.   In these patients, laser resurfacing may present an excellent option. 

Why is it called resurfacing?  Resurfacing is actually what the body does after the treatment.  The laser removes the outer layers of the skin very precisely and then the patient’s skin does the real work of resurfacing or healing over the dermis.  The laser doesn’t actually burn the skin, but rather ablates or vaporizes the outer layer with a very rapid laser pulse.   Wrinkles, texture irregularities and discoloration are removed along with these outer layers.  The patient’s own epidermal cells then emerge from the glands and hair follicles and cover over or “resurface” the deeper skin layers.  This produces a dramatic and lasting rejuvenation of the skin.  

Sounds great, but what’s the downside?  During the first week after treatment the skin is healing and this requires regular skin care and being out of sight.  Not unlike the Covid-19 lockdown but with frequent facial washing and reapplication of skin balm.  After that first week, the skin has healed, but remains pink for several additional weeks.   Given the downtime, many alternatives have been developed including chemical peels, “fractional” lasers, intense pulse light and radiofrequency micro-needling.  While these treatments may help improve skin discoloration, skin tone and texture, they usually fall short when it comes to significant wrinkle reduction.  This is where erbium laser resurfacing excels.  Over the last 20 years, we have found that patients who are good candidates and are properly prepared for the downtime do exceptionally well and are thrilled with the short and long lasting results.

Is an Arm Lift (Brachioplasty) Right For You?

Shortly after Michelle Obama was introduced as our country’s new First Lady in 2009, the images of her attractive and muscular upper arms caused social media to erupt. Women across the country sought to emulate her, and develop arms like hers. Exercise and a proper diet, while a key to good health, do not correct the contour problems of the upper arm. The culprit is excess skin. Loose skin of the upper arms has been a complaint of many women. Genetics and age play a role, as does a history of weight gain, especially if followed by a weight loss. Liposuction, while very effective for spot removal of fat, does nothing to tighten the skin. Exercise, while great for muscle tone, has no effect on the loose skin.

As plastic surgeons we deal with “loose” skin on a daily basis. We are smoothing the neck and jawline of the aging face, taking away bags and heaviness of the eyelids, tightening the tummy after a woman’s last pregnancy, and lifting the breasts when they droop either because of genetics and/or pregnancy and breast feeding. Loose skin is the predominate factor in each of these conditions. “Tightening” the skin is akin to altering a garment that is too large for one’s body. In altering a garment the tailor opens a seam to remove the excess material and contour the material so that it “lies well.” In tailoring one’s body we remove excess skin by excising it, which leaves a scar. This scar is equivalent to a seam. As in tailoring, we want a smooth contour and a flat scar, preferably one that is hidden, just like seams on our clothing. Whether it is a facelift, Brachioplasty, tummy tuck, or breast lift, we can hide the scars well.

Returning to the upper arms, a common operation we do is the arm lift or Brachioplasty, an operation which can make a dramatic improvement of the upper arm contour. We are unable to hide the scar as well as we can with the other operations, so the operation is more of a “trade-off.” That is, the patient can experience a dramatic change in the arm contour but has to accept a scar line that is not as well hidden. Despite this, patients are very pleased with the results.

Not a long operation, it is usually done under general anesthesia, though can be done with sedation and local anesthesia. The recovery is fairly easy. Pain is not usually an issue. Patients can shampoo and shower the next day, drive in two days, and return to light office type work as early as one week.

Napa Solano Plastic Surgery is ready to help you look better and feel better about your body. Contact the professionals at Napa Solano Plastic Surgery for your free consultation and find out if Brachioplasty is the right for you.