Are any of the injectable fillers that you use made of animal byproducts?
Posted February 11, 2010 3:16 PM
Question:
Are any of the injectable fillers that you use made of animal byproducts? If so, is it possible to have an allergic reaction?
Answer:
In the past I have used fillers such as collagen, some of which were made from animal byproducts and some of which were made from human byproducts. I no longer use those fillers. The fillers I use today are all synthetic hyaluronic acids, i.e. Juvederm, Restylane and Perlane. On occasion I will use Radiesse which is a calcium hydroxyapatite filler, again a synthetic filler. The fact that these products are not made from animal byproducts makes the likelihood of an allergic reaction extremely small.
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As a healthy 38-year-old man, what do I need to do to achieve
Posted February 10, 2010 2:44 PM
Question:
As a healthy 38-year-old man, what do I need to do to achieve the best outcome for my upcoming forehead lift?
Answer:
First of all, it is very important to obtain a very thorough consultation from a very experienced facial plastic surgeon. Forehead lifts are often performed to elevate the brows to relieve some of the heaviness in the upper face. In addition, forehead lifts are often combined with upper eyelid surgery to further improve the upper face.
There are multiple approaches to the forehead lift depending on the patient’s hairline. In particular in men, one must be extremely careful when choosing the approach. Some of the approaches include the endoscopic forehead lift, the pretrichial forehead lift, the coronal forehead lift which is rarely performed, and even a mid forehead lift. In my practice I prefer the endoscopic forehead lift in most patients as it allows me to elevate the brows to a more youthful position with very minimal incisions and very minimal scarring. It also does not alter the hairline which is very advantageous. Again, in my opinion, the best outcome first of all requires one starting with a very experienced surgeon who as a great deal of experience in forehead lifting surgery.
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I will be having facial liposuction next week
Posted February 09, 2010 1:08 PM
Question:
I will be having facial liposuction next week. I am very excited. If I am not satisfied with the results, what are my options to improve my appearance?
Answer:
First of all, one needs to be very careful in performing facial liposuction. One must seek a very experienced facial plastic surgeon to determine who is and who is not a candidate for facial liposuction. Typically, the one area where we do liposuction on the face is in the neck or just underneath the chin area. Blindly liposuctioning the cheek area is strongly discouraged as this can often lead to irregularities of the cheek. It is also very important for the surgeon to assess the elasticity of one’s skin. If one does not have adequate elasticity, facial liposuction alone will leave the patient with even greater looseness of their skin and a very poor result. Typically, facial liposuction is reserved for younger patients in their 20s, maybe early 30s. Beyond that it often has to be combined with a facelift type procedure to tighten and remove the excess skin following facial liposuction.
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After my gastric bypass surgery, I lost a significant amount of weight
Posted February 08, 2010 11:03 AM
Question:
After my gastric bypass surgery, I lost a significant amount of weight. My face looks very empty and my skin is very loose. What types of facial surgeries will give me a fuller face, a more youthful look?
Answer:
Multiple things happen with the aging process. Two of the more common things we see in the face are loss of elasticity and sagging of the facial skin. Also, what happens is the face does lose volume due to the fact that the bony skull actually shrinks, the muscles atrophy or shrink, and the fatty tissue of the face also shrinks with age. It is this volume loss, coupled with the loss of elasticity of the skin, which adds age to the face. There are multiple procedures which can improve the “aging face”. First of all, a facelift can be used to improve the looseness along the jaw line or jowls as well as the neck. In the upper face, commonly eyelid surgery is used to remove sagging or excess skin or puffiness around the eyes, and a forehead lift can be used to elevate brows which have also drooped over time.
None of the above procedures, however, will three dimensionally add volume to the face. It is very important to recognize the need for volume addition when rejuvenating the face. There are multiple ways to add volume back to the face including simple temporary fillers, some of the more common ones being Restylane, Perlane, Juvederm and Radiesse which all last an average of six months to a year and some even up to 18 months. These can be used throughout the face in the cheeks, the cheek folds, and along the jaw line, etc.
One of the more common places we lose volume is in what is called the mid face, which is a portion of the cheek. When I see significant volume loss in my patients, I often recommend a mid face implant, also called a submalar implant. The implant is placed through the gingival buccal sulcus, which is just underneath the upper lip. A small incision is made in this region and a pocket is made overlying the bone in this area. The implants, which are specifically designed for this area, are then placed through this pocket and fixated to the bone with a tiny micro screw so that there is no chance of shifting. I find that these implants work quite well because they are permanent and, therefore, they tend to be more cost effective than the temporary fillers in this region. The other advantage of these implants is that the body does not react to them and they are 100% reversible if for any reason whatsoever a patient does not like them or desires a change. There are also implants that are commonly used along the chin and what is called the pre-jowl area just lateral or on the side of the chin region.
Another commonly used implant is fat augmentation which uses the patient’s own fat to augment areas. It is important, however, for the patient to understand that a good portion of the fat injected will dissolve and so, therefore, this is a procedure that commonly has to be repeated. The fat that one keeps they will keep forever, but this tends to be a smaller amount than what they actually will lose.
It is extremely important to visit with a very experienced facial plastic surgeon who understands the aging process and the anatomy of the face, in particular in patients who have had gastric bypass surgery where there has been significant volume loss to the face, to determine what procedure is best to restore the natural youth back to the face.
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