1701 East Prospect Road, Fort Collins, CO 80525


Dr. Duncan at 5 Continent Congress (5CC) Barcelona

Dr. Diane Duncan returned Monday (happy Labor Day everyone!) from the 5CC conference in Barcelona, Spain!

It’s a congress attended predominantly by dermatologists and plastic surgeons; Dr. Duncan presented on her scarless breast lifting technique (trademarked by her as the PerkyLift a couple years ago), microneedling and dermaceuticals, nanofat combined with filler as an alternative to filler, and hair transplant graft bed preparation.  It was quite a lot (and, scheduled all in one day)!
Some of Dr. Duncan’s favorite discoveries were…
  • Fantastic PRP results from Elizabeth Houshmand, MD
  • An innovative stem cell processor created by her good friend and colleague Tunc Tiryaki, MD
  • Many forays into experimental areas of therapy, many trending towards more minimally-invasive techniques, across the board
Ultimately, many of these conferences present the chance to catch up with colleagues who have become friends and to create new relationships as well. Of course, there can sometimes be the sense that ‘being on the podium’ is of the utmost importance but more and more the genuine interest lies in education. The mingling of so many different backgrounds, areas of specialty, and therapy availabilities present an incredible opportunity for collaborations and innovations. Oftentimes some of the best ‘presentations’ are found being discussed in the hallway or in a corner of the exhibit hall. Dr. Duncan finds many of her new techniques, or brainstorms and collaborates with both companies and colleagues at these Congresses. 

Otherwise, Barcelona was enjoyed tremendously from the Cathedral and La Sagrada Familia to many good restaurants (Shoko, oh yum), the beach, and even a totally touristy trip to the IceBarcelona! Dr. Duncan also enjoyed the chance to practice her Spanish (even though Catalan Spanish is definitely different!)

EMSCULPT Has Arrived!

We are happy to announce that we are now providers of EMSCULPT by BTL! 

This machine is the first of its kind to build muscle while burning fat. Here in Colorado, the ‘fit’ aesthetic tends to predominate over simply slim, and until now muscle definition was only possible in the gym. Even then, many body types struggle to define certain areas despite many hours in the gym — EMSCULPT addresses that!

Tell me about the technology. 

High-Intensity Focused Electro-Magnetic or HIFEM field technology induces supramaximal muscle contractions. ‘Supramaximal’ means activation of ALL muscle fibers. 

How does muscle building happen? 

The brain controls normal voluntary muscle contractions. This means that the CNS (central nervous system) inhibits a new impulse while the previous one is still in action. Due to this, normal voluntary contractions allow the muscle fibers to relax between impulses. EMSCULPT bypasses that route with a high-frequency impulse that doesn’t allow such a relaxation phase
Normally, the highest amount of muscular tension that can be developed and held is the ‘maximal voluntary contraction’ or MVC. MVC’s usually only last for a split second. ‘Supramaximal’ occurs with tensions higher than the MVC. EMSCULPT can hold these contractions for multiple seconds. This significantly increases the muscle adaptation resulting from the physiologic workload. Exposure to this contraction level induces deep remodeling of the inner structure such as myofibril growth and new protein strands. Remodeling results in muscle hypertrophy and hyperplasia.  Definition and muscle tone appear as a result of increased muscle density and volume. 

What about the fat? 

Muscles require energy (adenosine triphosphate or ATP,  creatine phosphate and glycogen) to contract. Once those energy sources deplete, the body breaks down lipids from triglycerides into free fatty acids and glycerol
Supramaximal contractions alert the brain to the need for an enormous amount of energy. To supply this muscle expenditure the brain does a few things. Epinephrine release increases resulting in an extreme catabolic reaction and supramaximal lipolysis. This in turn (overwhelmed yet?) dramatically releases those free fatty acids (FFAs) we talked about earlier. Excessive FFAs accumulate in nearby adipocytes which leads to adipocyte (fat cell) dysfunction.

What should you expect? 

A consult with Dr. Duncan is mandatory before beginning EMSCULPT treatments. We will take two and three-dimensional photos, along with measurements prior to starting.  Photos and measurements will recur at every appointment. Treatment begins with one or two EMSCULPT applicators held to your stomach or buttocks with a band. Starting at 1%, contraction strength will increase with your tolerance. The treatment can feel ‘thumpy’, ‘tingly’, ‘intense’, or ‘tickly’.  One of our staff will be with you the whole time to ensure your comfort =). Strength can be adjusted as needed. As bare skin application optimizes the treatment, please be ready to remove your shirt or pants (especially if it contains metal). We recommend bringing a book as we don’t want electronics near the magnets =).  Immediately after treatment, the area will feel stronger and tighter, and over the next few days you may develop minor muscle soreness (but not so sore you can’t move like a big workout can do!).  

What’s New at PSA?

A lot has happened – are you ready for this? 

WebsiteAs you must know now (since you’re here, and reading this), Plastic Surgical Associates of Fort Collins, Dr. Diane Duncan’s private Fort Collins practice, has a brand-shiny-new website!  The new site brings a fresh, happy look along with some great information (most of which Dr. Duncan wrote and illustrated herself). Dr. Duncan has tremendous experience in face, breast, and body procedures, with multiple levels of treatment for each.  She performs full surgical, minimally invasive and non-invasive procedures for many areas of the body, all of which are broken down on the new website.
Whether here in casual interest, or seeking serious information, feel free to explore by body area, procedure type, or just scroll through our extensive before and after gallery!

Consult ProcessOur consult process has evolved in the past year and a half in order to give our patients (and potential patients) the best options for choice research, option information, and outcome control.
Initially, we have new patients start with a complimentary phone, online, or in-person consultation. We’ll ask that you send us some brief information (your story – the issues, goals, and preferably some quick photos) or come in to talk to one of Dr. Duncan’s knowledgeable assistants. Both options allow for patients to gather information about a variety of procedures, Dr. Duncan’s credentials and style, as well as ballpark pricing. We’ve found that this facilitates the consultation with Dr. Duncan as you are able to spend more of your consult time talking about you rather than learning the basics! Once complete, we schedule a consult with Dr. Duncan (these are $75 which will apply to any procedure you do with us!).
New use of TouchMD allows our patients to revisit their consultation with Dr. Duncan which will look something like this:
First, one of our assistants will introduce you to our practice, review your goals and desires, and take photos for you and Dr. Duncan to review together. PSA uses three different photo modalities:
Canfield Mirror is a 2D photo system: think traditional before and afters. This is our baseline monitoring system.
Canfield Vectra is a 3d rendering platform that allows Dr. Duncan to demonstrate shaping and expected post-operative outcomes specific to your body.  This new model is a recent installation and very, very cool. However, keep in mind that this is software manipulation, and that real life tissue response is not computer mandated!
FotoFinder is our more small-detail-oriented platform that we generally use for facial before and afters.
Second, this appointment is a chance for you and Dr. Duncan to sit down with your photos, and discuss what you would like to improve. Dr. Duncan will also take measurements if needed, and assess your unique anatomy & tissue type. She will discuss her recommended approach towards addressing your particular issue, drawing on 30+ years of experience as well as her persistent innovator experience.
Finally, a customized quote and potential treatment dates are reviewed with our Patient Care Coordinator. This, along with information about the recommended procedure(s) and photos will be added to your TouchMD account for your review post-consult.

EMSCULPT is a revolutionary electromagnetic technology application in the area of cosmetics. Two parts of the body the people tend to be most interested in improving, especially here in Colorado, are the abdominals and buttocks. Specifically, reduction of fat, improvement in lift, and size enhancement are the three main areas of the improvement sought.  Traditionally, this meant liposuction or a tummy tuck to address the abdominals, and fat grafting to the butt. EMSculpt uses electromagnets to stimulate muscle contraction which leads to enhanced muscle definition (think 20,000 crunches in half an hour!), and a cascading effect leading to concurrent fat loss. Much more to come on this topic!

StaffOver the past year we’ve made some amazing additions to our staff!
Tabitha joined us after graduating from CSU. She recently completed her MA certification but has a long history in healthcare experience. She is one of Dr. Duncan’s primary assistants both in clinic (there’s a good chance you’ll meet her at your in-person complimentary consult or at your first consult with Dr. Duncan!), as well as in surgery.
Brittany joined us while completing her MA degree. She is our fabulous all-around who can handle the front as well as clinical and surgical duties in the back!
Anna joined us after moving here from North Carolina. She will most likely be your first point of contact with our office; over the phone and when you walk through our front door.

Tl;dr: PSA has a shiny new website, a new consultation process, sweet new tech and awesome staff.

IMCAS Asia 2018

Dr. Diane Duncan recently returned from Thailand!

She was a faculty speaker and session chair at the conference and covered a multitude of topics from a non-surgical facelift (probably her favorite) to micro-needling and 3D imaging using Canfield Vectra.

Conference highlights ranged from:

  • Long nose rhinoplasty – many patients are scared of a full rhinoplasty, or hesitant since there is substantial downtime. Many times, a dorsal hump indicates the need for a traditional rhinoplasty but this method provides a possible alternative. Essentially, if the patient has a longer nose, it is possible to perform a closed rhinoplasty with a suture that pulls the tip up and disguises the ‘hump’ on the bridge of the nose.
  • There have been no reported cases of BIA-ALCL from smooth implant use. What is ALCL and how does it relate to implants? The FDA had announced that risk of breast implant-associated anapestic large-cell lymphoma (BIA-ALCL) was higher in women with textured implants as opposed to smooth implants.  Dr. Duncan only uses smooth implants (both Mentor silicone gel and the Ideal Implant structured saline are offered at our practice).
  • Finally, seeing friends. Many practitioners here have all met, grown, and continue to stay in touch from this particular Congress. Started in Paris in 2005 by Dr. Benjamin Ascher, the IMCAS conference continues to expand in size and locations around the world (Like Bali next year!).

Post-conference, Dr. Duncan spent a couple days in beautiful Chiang Mai, learning to cook (Thai is one of her favorite cuisines), seeing temples and butterflies, and taking in the classic sights of Thailand!

One of the biggest takeaways from the trip actually came from many of the people – the service here is astonishing. This level of personal interest and engagement in your experience is something we hope to expand upon at the practice.



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