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Dr Young (Bellevue / Seattle WA) discusses rhinoplasty before and after photos / procedure.

Tuesday, August 3rd, 2010

When evaluating a surgeon for rhinoplasty (Dr Philip Young of Bellevue / Seattle Washington), it is a good idea to look at as many before and after photos as possible.  One thing to realize is that there may not be that many photos for the particular surgeon even if that surgeon does these all the time.  Many people don’t want there pictures to be shown so that can limit the number of photos that a plastic surgeon is able to show someone.  The quality of the work is important to assess.  When the after photos were taken is important as well, as the results change over time.  In fact, the results of rhinoplasty can continue to change for 2 years and longer.  So you should look at afters that with that in mind.  During the recovery, the tip is usually the last to go down in swelling.  It can take several months for this to go down and could also change for many years.  This is good in many ways because your results will be gradual and it won’t look like something was done right away and it won’t be so obvious immediately. This can be good for your associations to get used to your look as it changes.  There are some things that you can do to speed up the recovery during the procedure.  I usually tack down the areas that are worked on so that the fluid doesn’t build up and the results become more apparent faster.  You should feel comfortable to discuss what things you notice, what things you like and don’t like with the surgeon and he should be really open to discussing things with you.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Rhinoplasty / Nose Surgery / Nose job / Nose Reshaping / Nasal Reshaping | Comments Off on Dr Young (Bellevue / Seattle WA) discusses rhinoplasty before and after photos / procedure.

Philip Young MD discusses otoplasty / ear cosmetic surgery cost and ways to evaluate the pricing

Monday, August 2nd, 2010

A frequent question that people have is how much does otoplasty / ear plastic surgery / ear shaping surgery / ear reshaping surgery cost.  There are some resources for the average cost of otoplasty that range from 2500-3000 for the surgeons fee.  That doesn’t include the costs for the facility and for the anesthesia and anesthesiologist.  The fee for the facility ranges from 500-2000.  The fee for the anesthesiologist ranges from 200-1000.  So the range for an otoplasty can be from 3200-6000.  We have a surgical facility near us and they charge 650 for the first hour for the anesthesiologist and each additional hour is 300 for each additional hour.  The facility is 1000 for the first hour and each additional hour is 500.   Sometimes, otoplasty is done for just one ear.  The costs for this can be lower. Usually surgeons reduce the price a little bit for otoplasty for 2 ears instead of one.  So you will usually pay a premium for the one ear.

It is good to find out what the average price for otoplasty is for your area.  You can do this by going to multiple consultations.  Sometimes you get what you pay for, as they say.  Somewhere in the average might be a good idea, at least do consider someone that is extraordinarily above the others unless there is compelling evidence that you think that person will do the job that justifies the pricing you receive.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Otoplasty / Ear Reshaping / Ear Shaping | Comments Off on Philip Young MD discusses otoplasty / ear cosmetic surgery cost and ways to evaluate the pricing

Dr Young talks otoplasty: Specifically the incisionless technique who it relates to age (Located in Bellevue, Issaquah, Seattle Washington).

Friday, July 30th, 2010

There are many ways to do this incisionless otoplasty.  But this can mean many different things.  When children are very young like less than 3 months old, you can mold the ear to permanently take on a new shape by just external molds. We have a system that does this.  But when you are a teen you need more involved approaches.  There are ways to do the incisionless technique but these methods are often less reliable than traditional techniques.  I often do incisionless otoplasty / ear reshaping through small punctures in the front of the ear to shape the ear.  These are better when the main cause of your ear appearance is due to a lack of fold in the periphery of the ear.  If the reason for your concern is due to the ear being too prominent because the base of the ear is too developed, the incisionless technique is even more less reliable.  The traditional technique can be done under local or iv sedation and is essentially a minimally invasive procedure and done through incisions in the back of the ear that usually heals imperceptibly in the back of the ear and as a whole.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Otoplasty / Ear Reshaping / Ear Shaping | Comments Off on Dr Young talks otoplasty: Specifically the incisionless technique who it relates to age (Located in Bellevue, Issaquah, Seattle Washington).

Dr. Philip Young talks about Pixie Ear Deformity Correction (Seattle, Washington):

Friday, July 30th, 2010

Dr. Philip Young talks about Pixie Ear Deformity Correction (Seattle, Washington): A pixie ear deformity is when the earlobe gets pulled down inferiorly so that it becomes elongated.  It often occurs after a facelift procedure when there is too much skin taken and not enough fixation of the muscle to hold up the lift.  Some people are naturally like this.  There are several ways to improve this situation.  Oftentimes it entails elevating the earlobe so that it is not as pulled down.  But it can entail closing the area below the new earlobe where the used to be.  Sometimes you can avoid this closure area by relifting the face and pulling the earlobe back by moving the skin backwards.

You don’t necessarily have to correct the other ear if you are satisfied with the way it looks.  But many things can be done to change the appearance of your ears if so desired.  These are all questions that you can ask your particular physician when you go into your consult.  I try to answer as many questions as my clients can think of during the consultation. I also offer my email for them to write me more questions if they have any given that people usually start wondering about more things after they leave.  I also check my email multiple times in a day so I can be attentive as possible to their questions and concerns.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Facelift / Face Lift / S lift / Mini Lift / Weekend Face Lift / Quick Lift / Image Lift, Otoplasty / Ear Reshaping / Ear Shaping | Comments Off on Dr. Philip Young talks about Pixie Ear Deformity Correction (Seattle, Washington):

Dr Young discusses the Healing time for Asian Blepharoplasty in a healthy, young male (Bellevue, Washington)

Friday, July 30th, 2010

This was a question someone asked about healing time for someone that is a young male as opposed to an older person in their 40-60’s.

You can’t guarantee anything in medicine and with surgery and that goes for Asian Blepharoplasty (Dr Young from Bellevue near Renton, Issaquah, and Mercer Island Washington) as well.  Based on my experience doing asian blepharoplasty, a month should be plenty of time.  You may not have people not notice at all though because Asian Blepharoplasty is an anatomical change to your eye appearance which people will notice of course.  But the swelling and bruising are usually markedly decreased by the time a month rolls around.  I sometimes see people back at a week and they are looking much better.  This is definitely not the norm though.  There are some things to speed up the recovery though.  Avoiding blood thinners is important for 2 weeks to a month before your procedure.  This can help decrease the oozing and hence the bruising and swelling that occurs with the oozing.  Also the skill of the surgeon makes a world of difference.  Dissecting in the right planes, anatomical planes decreases the oozing, and swelling.  The technique can make a huge difference. In terms of age, sometimes younger people have a much more robust inflammatory reaction to a procedure that can prolong the healing in some cases. Whereas in the older patient the decreased inflammation speeds up the healing.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Asian Double Eyelid Surgery / Asian Eyelid Surgery, Blepharoplasty / Eyelift / Eye Lift / Dark Circles / Eye Bags | Comments Off on Dr Young discusses the Healing time for Asian Blepharoplasty in a healthy, young male (Bellevue, Washington)

Dr Young blogs about Botox and the things that doctors usually recommend after botox (Bellevue, WA)

Friday, July 30th, 2010

Before botox, as I mentioned in a previous blog, you should always stay away from blood thinners 2 weeks before and after the procedure if you wanted to avoid bruising as much as possible.  We have a list of things / medications to avoid before and after botox that you can check out here. But other than that a recent number of consensus panel recommendations showed the preferences of plastic surgeons, dermatologists, and facial plastic surgeons:

100% agreed that you should not massage the area after botox, which I tell my patients as well.

78% said to contract your muscles to help activate the botox more. I tell my patients to contract their muscles as much as possible to help make the botox / dysport work. Doing this for 2 hours will help the uptake of the botox.

Only 30% said to limit your activity after botox. I suggest to all my patients to limit activity for the first 24 hours to avoid diffusion.

Only 29% said to avoid bending over after botox.  I tell my patients to avoid bending to prevent diffusion.

Only 20% mention to avoid heat after botox. I dont have a solid opinion on this as there is not enough information to say one way or another.

Only 13% of physicians mention avoiding flying after botox.  I don’t tell my patients to avoid flying.

Again, the maximal effect of botox is at 2 weeks and for dysport it is a little less than a week.

I hope that you enjoyed this and thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Botox, Dysport, Botulinum | Comments Off on Dr Young blogs about Botox and the things that doctors usually recommend after botox (Bellevue, WA)

Dr Philip Young MD’s thoughts on Famous people as patients and how he takes a different approach with this group when it comes to plastic surgery (Seattle, WASH)

Friday, July 30th, 2010

I have had the pleasure to operate on many people that are of significant backgrounds.  These people ranges from owners of very large companies, and very close family members of famous A listers from the acting and music industry.   One thing I have learned is that with these people you have to stick with what you believe in and have learned all of these years.  Because people of influence usually get there way, it is hard at times to stick with your principles.  What I’ve learned is that you have to stick with your principles otherwise you could give them a result that they don’t like ultimately in the end. I recently had a family member of a famous person.  They wanted something that I felt wouldn’t get a good result.  I had to be adamant that this wasn’t a good idea.  Sometimes, you have to figure out what is best for these patients and try to get them to believe in what you are doing.  If they don’t believe in what you are doing and are adamant about their own ideas, I refuse to do surgery for them.  I do this no matter how famous they are.  You can’t let their influence and their fame guide your professional and medical judgement.  I think based on my experience with this group that this is what goes on much in Hollywood where less than perfect results occur.  These results earlier in my career prompted me to find answers to aesthetics.  It culminated in my theory on facial beauty called the Circles of Prominence.  Here is a copy of my facial beauty paper on my website.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Hollywood Plastic Surgery / Hollywood Stars, My Journey to Find and Attain Beauty | Comments Off on Dr Philip Young MD’s thoughts on Famous people as patients and how he takes a different approach with this group when it comes to plastic surgery (Seattle, WASH)

Dr Young’s ideas on Singer Charice and her quests to change her look through Plastic Surgery (Bellevue, Washington)

Thursday, July 29th, 2010

Charice is a wonderful singer as I have seen her perform on Oprah.  Recently, there has been information on her seeking the advice from plastic surgeons.  What has been talked about is her recent use of botox for her episode on Glee.  Botox is great for younger people to keep the wrinkles at bay.  Especially when they get nervous and start to create alot of wrinkles in their forehead, in between their eyes and crows feet.  In can give people the impression that they are more relaxed than what is really going on inside.  Many times when people get nervous they may lose their sense of how they are appearing.  They crunch their eyebrows and it makes them look mean.  They raise their eyebrows when they get nervous and you can tell they are nervous.  Botox comes all of those things down and you look better, more relaxed, and not as nervous.

She also is inquiring about make her face less round and what she can do to make her self look better.  I did an analysis on her based on my theory on facial aesthetics.  Although her face is tilted.  In general what the diagonal lines are showing you is that her cheeks and lower cheek areas are really dominate.  The middle oblique, and the vertial line is where the shadowing should be increasing markedly as it you go from lateral and inferiorly.  But  you see in the picture that her cheeks still are showing a lot of highlight in this area.  This is seen in the first figure.  The second are before and afters of my morphing to show you how she would look with some jaw and cheek reduction surgery and rhinoplasty.  I think she could look a lot better by narrowing her face and also making her nose a little smaller in the tip area.  She might also need some mesotherapy or microliposuction in her cheeks.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Cheek Augmentation, Hollywood Plastic Surgery / Hollywood Stars, Jaw reshaping / Jaw Implants / Jaw Augmentation, Rhinoplasty / Nose Surgery / Nose job / Nose Reshaping / Nasal Reshaping | Comments Off on Dr Young’s ideas on Singer Charice and her quests to change her look through Plastic Surgery (Bellevue, Washington)

How do I prepare for a filler and what kind of post care should I think of after a filler?

Friday, July 23rd, 2010

Fillers (Dr Young from Aesthetic Facial Plastic Surgery, PLLC in Bellevue, WA) are products that are used to volumize your face.  As you age, you lose volume in your face and these fillers replace this volume.  The most common fillers include restylane, radiesse, juvederm, and perlane.  These are the top four products being used.  So what are some of the things you should be thinking about with filler.  Well to begin with you should not be allergic to any of the products including hyaluronic acid, calcium hydroxyapatite, carboxymethocellulose, gram positive bacteria especially streptococcus, lidocaine or amide type local anesthetics, or a history of multiple allergies or severe reactions to certain medications.  I usually tell people to refrain from high dose vitamin E, herbal medications, supplements, fish oils, omega 3’s, anti-inflammatories (naproxen, aleve, ibuprofen, advil, indomethacin, motrin, excedrin, piroxicam, sulindac, etc.), aspirin 2 weeks before and after the procedure included with this list are some obvious ones like warfarin, coumadin, heparin, lovenox, plavix. Here is a more formal list of medications to avoid from our website.  I do this because these elements / medications can cause bleeding and if you avoid these during this time frame you can avoid extra bruising and swelling.  Arnica and bromelein have shown some benefits but are still being studied and are not a standard in treatment for plastic surgeons so I don’t really recommend it.   This pre filler care will help with the post care.  You should discuss during your consultation the risks and benefits of the use of restylane. During the filler you will have some choices for the type of anesthesia you can get for the filler injections. Now most fillers have lidocaine in the preparation to make it more tolerable.  These are the options:

1. Use ice then inject. Can work but by numbing the area with the ice.  With the local in the filler, you may feel it go in initially with each stick in any new area. But subsequent injections will be more numb with the anesthesia in the filler itself

2. Use topical anesthesia first and then inject.  This is a good option.  The topical makes the skin numb, you may feel the injection go into the deeper layers. But like ice, it will feel like a stick in the new area and then get better with subsequent injections.

3. Local anesthesia and regional anesthesia, so called “dental blocks” to numb the nerves that innervate specific regions.  This is the best way to make it so that you don’t feel anything.  For some it is over doing the anesthesia.  Sometimes, people who get anxious can get reactions to the local anesthesia and you can get an anxiety situation where your heart rate goes up as well as your blood pressure.  This happens about 1 out of 25o times a filler gets done with local / regional anesthesia.

After the filler, you should ice the area especially for the first 48 hours.  I usually suggest 10 minutes for every hour.  I also stress that you should not have the ice directly on the skin but have a barrier to prevent damage to your skin.  This icing will keep the swelling down and also the bruising to a degree.

For the first two weeks, I usually suggest people to massage the area of the filler if there are certain areas that are more elevated and pronounced than the other areas.  Most of this uneveness if it is present will be improved with this.  When the filler is in the lower eyelid area, you need to pull down the swelling over the bone and then massage it from there to effect it.  After the first two weeks, I then suggest to consider more massage if the elevations are subtle and if large then you can consider enzyme injections or hyaluronidase injections which are very potent in reducing unwanted swelling from filler.  Now with radiesse there is no enzyme that will do the same and you have to just massage the area to make it go down to a point that you like.

If you have any questions you can always email me or ask me through this blog

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Fillers / Facial Fillers, Juvederm, Perlane, Radiesse, Restylane, Uncategorized | Comments Off on How do I prepare for a filler and what kind of post care should I think of after a filler?

Cleaning your incisions after any procedure that requires suturing.

Friday, July 16th, 2010

This is a blog to discuss how to clean your incisions after any surgical procedure. The key for healing is to remove all crusting and to start with an incision that has the skin edges as close as possible together. The crusting is important to remove because the crusts can be nourishment for bacteria that can proliferate and cause more scarring. I usually suggest to my patients that they use vinegar and distilled water in a 1:3 dilution to clean the incisions. I tell people to do this twice a day. The goal is to get there incision to look like a fine wrinkle. If they keep doing this during the first 2 weeks the incision has the potential to heal incredibly. Always have vaseline over the incisions. It has been scientifically shown that skin cells grow faster when they have two surfaces to grow on. The vaseline serves as the other surface and this promotes the healing. You want the skin cells to grow over the incision as fast as possible. This reduces the scarring. Some people advocate hydrogen peroxide. I would caution that the use of this can be risky. I use the same dilution with hydrogen peroxide and distilled water in a 1:3 dilution. The key with the use of hydrogen peroxide if you are going to take the risk is to use it sparingly. You just want to use it to take the crusting off and then stop. If you do this more than that you can have more scarring. So being conservative is very important. If in doubt don’t use the hydrogen peroxide. And if you do use it, do so for only the first week and that is it. You should continue to clean your incision for about the first two weeks and keep vaseline on the incision at all times. After this you can do regular skin care and use sunscreen during the day (approximately 12 hours) and then silicone gel during the evening for 12 hours. The silicone gel can be found at any pharmacy or drugstore, like Bartells. I would do the silicone gel for the next 3 months. It is one of the only things that have statistically shown to make a difference in preventing scarring. Vitamin E, aloe vera, mederma based on my knowledge and recent literature search (05 / 2010) does not make a scientific difference. Following up with your doctor is really important to do so that they can make sure that you are on the way to healing the right way!

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Posted in Scar Removal / scar reduction / scar revision / scar treatment, Skin Care / Intense Pulse Light, Uncategorized | Comments Off on Cleaning your incisions after any procedure that requires suturing.

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