Belly measurement, tummy tuck plastic surgeon in Nashville, TN, offers breast augmentation, breast lift, breast reduction and liposuction.

So, you want to reduce the appearance of fat but want to avoid surgery? Nonsurgical fat reduction may be just what you need.

Why consider nonsurgical fat reduction?

Following are some common reasons why you may want to consider nonsurgical fat reduction:

  • You are in relatively good shape but have modest bulges of fat on your abdomen, flanks, back or thighs that you’d like removed.
  • You have pockets of fat that are resistant to diet and exercise .
  • You wish to achieve a trimmer look without having to undergo an invasive surgical procedure.

It is important to note that nonsurgical fat reduction is not a weight loss treatment. This procedure is best suited for treating very limited volumes of fat of the abdomen, flanks, back and thighs. Because larger volumes of fat require multiple nonsurgical treatments, liposuction is probably a better option for larger fat accumulations.

What is nonsurgical fat reduction?

Nonsurgical fat reduction is a procedure that uses specialized equipment to create a controlled injury to small volumes of fat. Currently, there are two types of devices used for nonsurgical fat removal: ultrasound and cold energy or cryolipolysis. Both allow outpatient treatment resulting in efficient and consistent fat reduction as well as enhanced body contour.

  • Effective in diminishing stubborn areas of unwanted body fat.
  • Outpatient treatment with little to no downtime and minimal discomfort.
  • No incision required.
  • Multiple treatment sessions may be needed to produce satisfactory results.
  • Small burns are extremely rare but have been noted with ultrasound devices.
  • Temporary redness and numbness may occur.
  • These are the top three pros and cons to weigh when considering nonsurgical fat reduction. If you want to focus on those specifically unique to you, please consult with your aesthetic plastic surgeon.

The two main types of nonsurgical fat reduction

Depending upon your needs, your surgeon may recommend one of the following treatment modalities:

  • Premedication is usually not needed.
  • Your treatment areas are marked by your surgeon.
  • A technician applies a thin layer of gel to your skin.
  • The ultrasound transducer head is then moved over the treatment area. The same area may be treated more than once.
  • Your session may last anywhere from a half hour to several hours.
  • The fatty area is sucked up into a handpiece between two metal plates and the area is slowly cooled.
  • Current treatment guidelines are one hour per site.


Though clinical studies show cryolipolysis works, this is an “off-label” treatment according to FDA guidelines. The FDA acknowledges that “off-label” treatments may represent the state-of-the-art treatment.

There are currently two types of devices used for nonsurgical fat removal: ultrasound and cold energy or cryolipolysis. Your board-certified plastic surgeon will determine what is best for you based on his or her experience, your body type and your cosmetic goals.


Think about ultrasound energy like sunlight. A magnifying glass can focus sunlight to ignite paper. Above and below the point of focus, paper does not burn. In a similar manner, by focusing ultrasound energy, only fat near the focus point is injured. Your skin (above the focus point) and tissue (below the focus point) are protected. Your body then slowly absorbs the damaged fat. One or more treatments may be needed.


This treatment disrupts fat using a form of controlled frostbite. Research has shown that during frostbite fat cells freeze before skin freezes. Cryolipolysis works in the same way, freezing fat but not your skin. The “frozen fat” dies and is absorbed by your body over time. One or more treatments may be needed depending upon the amount of fat to be eliminated.

Preparing for your procedure

Your surgeon will provide you with pretreatment instructions and answer any questions that you may have.  In advance of your procedure, your surgeon will ask you to:

  • Stop smoking before undergoing treatment to promote better healing.
  • Avoid taking aspirin, certain anti-inflammatory drugs and some herbal medications that can cause increased bleeding.
  • Regardless of the type of procedure to be performed, hydration is very important before and after treatment for safe recovery.

Nonsurgical fat reduction is usually performed on an outpatient basis. Be sure to arrange for someone to drive you home after treatment and stay with you at least the first night following treatment.

Now that you know more about nonsurgical fat reduction, you’re ready to discuss it with a member of our team and decide if it is right for you.

You’re seeking a firmer, more youthful look. You want to remove the loose skin that comes with aging. You’re simply seeking to improve your appearance and the quality of your skin – but you don’t want surgery. If so, nonsurgical skin tightening could be right for you. Here’s more on what you can expect and how to determine if this treatment is best for you.

You may be a good candidate for skin tightening:

  • If you have mild to moderate loose skin on your face, neck, arms or abdomen
  • If you have residual skin laxity after an operative procedure
  • If you would like an improvement in the quality of your skin
  • If you are unable (or unwilling) to undergo a more invasive, surgical procedure to correct skin laxity


  • A noninvasive, nonsurgical technique that tightens facial or body skin
  • Performed with no incisions, minimal discomfort and little to no downtime
  • May be used for all skin types


  • Results are less extensive and dramatic than those obtained with a facelift or body contouring procedures
  • Multiple treatments are usually needed for optimal results
  • Skin redness, temporary swelling or numbness or volume loss around the treated area may occur

These are a few of the pros and cons to weigh when considering nonsurgical skin tightening. If you want to focus on what is unique to you, please consult with your aesthetic plastic surgeon.

Methods of Nonsurgical Skin Tightening

The three primary methods of nonsurgical skin tightening are radiofrequency, intense pulsed light (IPL), and ultrasound.


  • The treatment area is measured and marked
  • Your skin is cooled for comfort and safety
  • A specially designed treatment tip is placed against your skin
  • Radiofrequency energy penetrates deep into the skin’s tissue, heating the treatment areas and stimulating collagen production
  • You will feel a gentle vibration as well as cooling and heating sensations during each pulse
  • The upper layer of your skin is cooled

Intense pulsed light (IPL)

  • If your face will be treated, you will be provided with protective eye covering
  • A handpiece is used to administer a continuous cooling while an infrared light heats the deep dermis (deep layer of your skin)
  • One or more passes may be performed


  • The treatment area is measured and marked
  • An ultrasound gel is applied to your skin
  • A smooth handpiece is placed on your skin and an image of the tissue beneath is projected on a screen so your surgeon can see the treatment area
  • The ultrasound emits small thermal bursts to stimulate the deep structural support layers of the skin without disturbing the skin’s surface

Your Treatment Options

There are three general options for nonsurgical skin tightening. After evaluating your skin quality and the area being treated, your plastic surgeon will choose the option that is best suited for your particular situation and will recommend an approach based upon your aesthetic goals.

Radiofrequency and intense pulsed light treatments heat only the deep layer of your skin. The epidermis or outer skin layer is not damaged. Your body’s natural wound healing response causes collagen changes in the skin which results in skin tightening. A series of treatments is usually performed.

Ultrasound treatments focus ultrasonic energy to the dermal layer (the deep layer of your skin). Your skin above the focus point and tissue below the focus point are protected. New collagen growth is stimulated, which gradually lifts and tightens the skin. Like radiofrequency and IPL, multiple treatments may be needed.

Preparing for a nonsurgical skin tightening procedure

Your plastic surgeon will provide you with pretreatment instructions, answer any questions that you may have, take a detailed medical history, and perform a physical exam to determine your fitness for treatment.

In advance of your procedure, your plastic surgeon will ask you to:

  • Stop smoking for at least six weeks before undergoing treatment to promote better healing
  • Avoid taking aspirin, certain anti-inflammatory drugs, and some herbal medications can cause increased bleeding
  • Discontinue any topical skin products that might increase your risk of complications from treatment
  • Regardless of the type of treatment to be performed, hydration is very important before and after surgery for safe recovery

Nonsurgical skin tightening is usually performed on an outpatient basis. Be sure to arrange for someone to drive you home after your treatment and to stay with you at least the first night following your procedure.

How long will you see the benefits of your procedure?

Most nonsurgical skin tightening results will last one to three years on average. Subsequent procedures may need to be repeated periodically in order to maintain the benefits.

Maintain a relationship with your aesthetic plastic surgeon

For safety, as well as the most beautiful and healthy outcome, it’s important to return to your plastic surgeon’s office for follow-up evaluation at prescribed times and whenever you notice any changes in the skin that has been treated. Do not hesitate to contact your surgeon when you have any questions or concerns.


Botox in Nashville, TN, Dr. Sieveking on runners face, Botox injections, Juvederm and Juvederm Ultra

( – Runner’s Face. Not referring to the aggressive face an athlete makes prior to crossing that finish line.  Runner’s face generally occurs in both men and women ages 40+ who exercise to improve their body, and in doing so end up with a skeletal and bony face. When exercising, an athlete burns off fat beneath the layers of his/her skin. The marked loss of fatty tissue results in a loss of volume which leads to a prominent appearance of the bones, accelerated development of skin laxity and deepening of wrinkles. Though you may look like a 20-year-old from the neck down-your face will easily give away your age. If your skin has taken a beating from pounding the pavement, there are ways to chase those wrinkles away. Runners often have wrinkles for reasons other than running itself. Many runners spend long hours outdoors without proper sun protection, so the wrinkles are a result of sun exposure. Runners are also often people who have lost a lot of weight, so the wrinkles are from the skin that was previously filled with fat.

“There are several solutions to rejuvenating gaunt, aged skin which has developed wrinkles or volume loss,” explains Nashville, TN Board Certified Plastic Surgeon Dr. Nicholas Sieveking. Dr. Sieveking is not criticizing women who run; he is simply making them aware of the consequences of pounding the pavement.  “Rejuvenating your appearance can include both surgical and non-surgical procedures.” A combination of Botox and injectable fillers such as Restylane, Juvederm Ultra and Radiesse can smooth wrinkles and restore fullness to the face, while further preventing signs of aging. Botox treatments can target lines in the brows or around the mouth, but the result typically lasts about three to four months. Injectable filler treatments to restore volume provide results which last at least a year, and often much longer than that. “In some patients, I’ve seen Botox last the full four months, but I’ve also seen instances where results have only lasted two months – everyone is different,” says Dr. Sieveking. Dr. Sieveking’s experience has proven that Juvederm and Radiesse usually last about twelve to sixteen months. Restylane, which is used mostly for finer lines and wrinkles, not deeper contours, tends to last for six to twelve months. For Runner’s Face, Dr. Sieveking’s recommendation for filling is Juvederm Ultra, which can restore volume to chin, cheeks, and cheekbones that become hollow or thin due to weight loss or age-related facial fat loss. This product reliably lasts up to 18 months.  “Fat grafting would be the best option for natural, long-lasting restoration would be the best option for natural, long-lasting restoration of volume loss in this group of patients, but unfortunately in this group of patients there is typically very little to no fat in other areas to take from.”  Non-invasive treatments like chemical peels, laser skin tightening, photodynamic therapy, portrait plasma regeneration assist in eradicating the lines formed within the skin itself, such as around the mouth, and greatly contribute to producing a more youthful appearance.  For true correction of sagging skin, more invasive procedures may be required. Eyes tend to show the first signs of aging, an eyelid lift or brow lift will rejuvenate the eye area and take years off your face.

Dr. Nicholas Sieveking is a board certified plastic surgeon who completed his training in General Surgery and Plastic and Reconstructive Surgery at Stanford University. After Stanford, he received additional fellowship training in Aesthetic Surgery in Rio de Janeiro and São Paulo, Brazil. In addition to his plastic surgery board certification, Dr. Sieveking is also board certified with advanced fellowship training in Anti-Aging and Functional Medicine. This double board certification enables Dr. Sieveking to be the most complete anti-aging surgeon and physician to treat his patients age-related needs, from the inside to the outside. Dr. Sieveking’s comprehensive solo practice includes advanced cosmetic and reconstructive surgeries, state of the art cosmetic laser and skin care services, Bio-identical hormone replacement therapies, medically-supervised weight loss programs, and cutting edge laboratory testing for hormone, amino acid, vitamin and nutrient deficiencies as well as toxin analysis and food and chemical sensitivities testing.

Dr. Sieveking has operated and lectured around the world on topics of facelifts, breast surgery, and cleft lip and palate repair. He has authored a chapter on Rhinoplasty in one of the major training textbooks for plastic surgery residents. In 2012 and 2013, he was voted “Top Plastic Surgeon in Nashville” in two Readers Polls by the citizens of Nashville, TN.

Source: Do You Have ‘Runners Face?’

Inside Cosmetic Surgery Today – Facelifts & Nose Surgery – What You Must Know Before You Decide: Dr Lycka & Dr Sieveking

Facelift surgery is the ultimate anti-aging treatment, and as with any surgery, it should not be entered into lightly.  And the same goes for a ‘nose job’ – aka rhinoplasty surgery. Both surgeries require careful thought and planning beforehand, and need an experienced and artistic plastic surgeon to perform them. Questions and uncertainty are rife with these two procedures so this week on Inside Cosmetic Surgery Today we are talking with a renowned plastic surgeon who specializes in them, to help inform you and put your mind at rest. So Dr Nicholas Sieveking, from his Nashville, TN practice talks with Inside Cosmetic Surgery Today show host, Edmonton-based cosmetic dermatologist Dr Barry Lycka and the two doctors talk in-depth about facelift surgery, planning, and recovery. Read full article.

Do I Need a Facelift?

Between the age of 40 to 60 the aging process makes the face and neck sag. The skin gets less elastic, muscles become weaker and gravity pulls it all down. Skin on eyelids develops into folds, wrinkles deepen at the corner of the mouth. The area droops and the jaw line becomes floppy. The angle between the neck and chin become less clearly defined. How quickly this happens depends largely on genes, although smoking and exposure to sun can accelerate the process.

The Term Facelift Covers Various Procedures

People often want to know how long the effects last and in research, in the journal Plastic and Reconstructive Surgery, answers this question by using standardized measuring techniques and a validated rating system. In this study, 50 people who had had a facelift after 2001 had facial measurements taken by a computer, as well as before and after photographs assessed by five independent raters. The study found that five and a half years after surgery, 76% of people still looked younger than before their facelifts. The neck sagged the most after surgery and the improvement of the angle between the chin and neck seen after the facelift was observed to have reduced in two-thirds of people. In the hands of an experienced surgeon side-effects should be rare, but a list of possible consequences from the American Society of Plastic Surgeons includes skin discoloration and sensation loss. The “wind tunnel” look of wide eyes and mouth should not occur with a good board certified plastic surgeon in Nashville, TN.

Facelift before 50

Facial aging varies greatly depending on factors like whether you smoke, but in general there are good reasons most board certified plastic surgeons aren’t performing the traditional, full face lift for Nashville, TN patients younger than their late 40s / early 50s. Typically the biggest reason is the fact that at this point you’re only beginning to see the “big” signs of aging that a facelift treats – nasolabial folds (also known as “parentheses”), muscle laxity, and drooping of facial fat and skin.

Other Options for Nashville, TN, Patients Younger Than 50

Younger patients may be better off with one of these options for the time being:

  • BOTOX® Cosmetic / DYSPORT® injections (to smooth dynamic wrinkles)
  • Injectable fillers (to fill out facial hollows and improve fine lines)
  • Laser treatments (to improve skin texture, reducing both dynamic and static wrinkles)
  • Mini facelift (to tighten skin and muscle enough, but not too much)

In general, if you feel that your Nashville, TN, board certified plastic surgeon is pushing for “too much too soon,” follow your instinct and ask “why.”

Nashville, Tennessee, plastic surgeon Dr. Nicholas Sieveking — who also doesn’t call the actress a patient — agrees, saying the “surgery has left her nasal tip and nostrils uneven and the dorsum [nasal ridge] a bit crooked.”

NOSE – While Debra has never looked anything short of gorgeous, “An apparent rhinoplasty has given her nose an ‘operated on’ look,” observes Nashville, TN plastic surgeon Dr. Nicholas Sieveking.

JAWLINE – “It looks as if she’s had fillers in the prejowl area [on either side of the chin] that made her jaw appear more square,” says Nashville’s Dr. Sieveking.

Dr. Sieveking plastic surgeon Nashville, TN in Life and Style nose surgery, Botox, Juvederm, Dysport, facelift and plastic surgery.



20 questions to ask before your Nashville, TN facelift

How To Diet For Clear Skin Without Acne

It’s easy to overlook our gut as the source of skin troubles. But if the well-being of our internal organs and energy levels are determined by what we put in our mouths, why shouldn’t the same be true for our skin?

Our friend and Stanford-trained, board certified plastic surgeon in Nashville, TN, Dr. Nicholas Sieveking, agrees. An unhealthy gut can often trigger the signs of aging and unhealthy skin that we all look to avoid. “Any disruption can create inflammation, affecting the integrity and protective function of the skin,” Dr. Sieveking explained.

Did you know an unhealthy gut can lead to a drop in the power of the skin to fight infection and inflammation? Research shows that small intestine bacterial overgrowth (SIBO), a condition involving inappropriate growth of bacteria in the small intestine, is ten times more prevalent in people with acne rosacea, and that a correction of gut flora led to marked clinical improvement in their skin conditions.

Dr. Sieveking explained the impact of gut flora in our bodies. The expert shared that altered gut flora can activate the release of substance P — a neuropeptide produced in the gut, brain and skin that plays a major role in inflammatory skin conditions like eczema.

An unhealthy gut can result in many issues such as maldigestion and the malabsorption of proteins, fats, carbs and vitamins, but these problems also show up in our skin. “SIBO can lead to nutritional deficiencies including vitamin B12, as well as vitamins A, D, E and K, which are all critical for optimal skin health and overall good health. An imbalance of stomach acid can result in the overgrowth of ‘bad’ bacteria in the colon, which can lead to acne as well,” the expert noted.

But thankfully, correcting your gut flora and establishing a healthy glow, both on the inside and out, doesn’t need to be complicated. Check back this week to learn the five easy steps you can take to start the healing process.

Source: Eat Your Way To Healthy Skin: How To Diet For Clear Skin Without Blemishes