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How often are ear and rib cartilages used for rhinoplasties?

Tuesday, April 20th, 2010

Ear and rib cartilage grafts usually are less than 10% of primary rhinoplasties (Dr Phil Young of Seattle / Bellevue WA).  Usually there is enough cartilage from the nasal septum to use for rhinoplasties.  This also depends on what kind of practice the surgeon has.  If they have a good reputation and a lot of experience, Secondary rhinoplasties or rhinoplasties that are the second time around are more common.  In this situation cartilage grafts from the ear and rib are more common and it varies for all surgeons.  It also depends on the ethnicities of the person.  Caucasians usually have more prominence of the nose and usually request making the nose smaller.  This requires taking cartilage out and in this instance the less cartilage is needed.  For other races, cartilage is usually more of a shortage and thus requires more grafts and in this case either foreign implants, or grafts from the rib or ear are taken.  Since taking rib is such an undertaking, patients usually opt for implants such as silicone, med por, and goretex are used.   Ear cartilage can be used but given its pliabilty and curvature it is less than optimal for many grafting needs and are more used for tip grafts and grafts for the cartilage that make up the tips.

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 How often are ear and rib cartilages used for rhinoplasties?

Can chemical peels lead to cold sores?

Tuesday, April 20th, 2010

A chemical peel (Dr Young of Bellevue Washington) can cause a reactivation of the herpes virus that leads to cold sores.  Some 90% of people are infected or have been infected by the Herpes Virus simplex 1 that cause oral herpes.  Chemical peels, resurfacing, dermabrasion all stimulate the skin that can reactivate the virus that usually resides in the sensory nerves (dorsal ganglion).  These peels or procedures stimulate the nerves, decrease barriers and active the virus to come down the nerves to the cause the cold sores.  They don’t actually lead to a new infection, they just reactivate the virus that has been there since childhood.  Usually if the peel is more than superficial, I will prescribe acyclovir, or vacyclovir as prophylaxis. I don’t always do that for superficial peels like glycolic, low strenght tricholoracetic acid, or jessner peels, etc.  Laser resurfacing, dermabrasion, and medium to deep depth chemical peels usually require prophylaxis.

Thanks for reading, Dr Young

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

Posted in Chemical Peels, Laser Resurfacing | Comments Off on Can chemical peels lead to cold sores?

I had 2 facelifts and my surgeon is suggesting fat grafting to my face for facial rejuvenation by Dr. Philip Young Bellevue | Seattle:

Tuesday, April 20th, 2010

I had 2 facelifts and my surgeon is suggesting fat grafting to my face for facial rejuvenation by Dr. Philip Young Bellevue | Seattle: Fat is a great option after multiple facelifts (Dr Phil Young Seattle / Bellevue Washington) to volumize the face.  Aging can be seen as a process of changing from a grape to a raisin for lack of a better descriptive scenario.  Facelifts essentially make the raisin into a smaller raisin. When in fact to look younger a lot of times looking like a fuller younger naturally looking grape is the better option.  This is where volumizing plays an important role.  Fat injections volumize the face to return the raisin to the grape that it used to be.   Given that you have had 2 facelifts, you likely have a reduced skin volume and hence you will be smaller than the grape you once were, unless you gained alot of weight during the years.  Volumizing would be excellent for you likely.  But it all depends on what you look like and this is a general comment.  At the age of 74, you can still get benefits from facial fat grafting.  I have done a lot of patients over this age. It all depends on your health.  Of course you need enough fat to do the procedure and your surgeon can tell you about that or assess this situation. Here is a youtube video showing fat injections into the cheek (Dr Young fat injections to the cheek)

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, Fat Transfer / Fat Injections, YoungVolumizer | Comments Off on I had 2 facelifts and my surgeon is suggesting fat grafting to my face for facial rejuvenation by Dr. Philip Young Bellevue | Seattle:

Can lasers improve the turkey neck?

Monday, April 19th, 2010

Lasers can improve the Turkey Neck but to a minimal degree.  This is a good option for people that are not ready for surgery.  The laser can tighten the skin, improve the wrinkles and decrease the aging that occurs with sun damage.  One thing to consider that it is better to be safe than sorry in the neck.  The neck skin is thinner and has more potential for scarring and other healing issues.  So being conservative is vital in the neck area.  But to definitely treat the neck a traditional neck lift is the proven way to rejuvenate the neck.  Another option is fat injections and the YoungVolumizer for the neck. After all, a big part of aging in the neck area is a loss of volume under the skin. Here is a live demonstration of my use of a co2 laser and laser resurfacing.

Thanks for reading, Dr Young

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

Posted in Laser Resurfacing, Necklift / Neck Lift / Platysmaplasty / Turkey Gobblers / Neck Bands, YoungVolumizer | Comments Off on Can lasers improve the turkey neck?

What fills in the hollow under the eyes, do implants work there?

Monday, April 19th, 2010

Eye / Inferior orbital rim Implants can fill in the hollows under the eyes. Volume loss in the cheek and under the eye along the inferior orbital rim can lead to the hollowing under the eye that makes the bags under the eyes stand out.  There are many ways to fill in that hollow. You can use fillers, fat injections, the YoungVolumizer, Implant (Dr Young Seattle Washington), and you can sometimes reposition the fat over the rim.  Taking out the lower eyelid fat reduces the baggy appearance but doesn’t correct the original reason why there is a hollow there in the first place which is due to volume loss. Here is a video on a live facial fat injection (by Dr Young of Bellevue, Washington) on youtube.

 

Thanks for reading, Dr Young

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

Posted in Blepharoplasty / Eyelift / Eye Lift / Dark Circles / Eye Bags, Fat Transfer / Fat Injections, Fillers / Facial Fillers, YoungVolumizer | Comments Off on What fills in the hollow under the eyes, do implants work there?

Solution for a person with large nasal skin envelope.

Saturday, April 10th, 2010

This is a patient that did not like the size of his nose and wanted it to be less wide and also wanted his tip to be less droopy and more elevated and smaller if possible.  This solution that I discovered avoids large incisions on the bridge of the nose or above and can lead to incisions that hide well inside the nose.  The below picture shows how we planned the alar resection next to the nostrils to make the nostrils smaller and the nose less wide (1st figure).  Now this was done with an open approach where we made an incision in the columnella.  This is  the structure that is made from the medial crus (take a look at our anatomy picture for a better visual on where the incision is made).  The columnellar incision is made on the inferior side between the nostrils and hides very well. I have a picture of this on my website on the rhinoplasty procedure page (Dr Young of Bellevue near Seattle Washington). There used to be a lot of fear of devascularizing the nasal tip by doing the rhinoplasty open and then also resecting the alae (see alar fibrofatty tissue on the nasal anatomy picture below 2nd figure).  We did this persons procedure below and was able to get an excellent result without causing any nasal tip skin loss.  More importantly, we had to figure out how to change the thick nasal skin on this persons nose.  I developed a way of taking away skin without making any incisions on the top of the nose where it is more visible.   The 3rd picture shows how we made the nose skin smaller by taking away skin from the bottom and within the nose.  I first made an incision down the middle of the lobule part of the nose just under the nasal tip and then made the corresponding angle part of the incision of the transcolumnellar scar that is like an inverted gull wing incision.  This was further taken to the soft triangle area where the wings of the incisions are shown in the third picture. The blue shaded area is where the skin was taken. When the incisions were closed they rested inside the nose so the scarring was all inside the nose hidden.  I judged how much skin to take by tensing the skin over the tip and determining how much tension was on the closure at the transcolumnellar site.

Thanks for reading, Dr Young

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

Posted in My Journey to Find and Attain Beauty, Rhinoplasty / Nose Surgery / Nose job / Nose Reshaping / Nasal Reshaping | Comments Off on Solution for a person with large nasal skin envelope.

My visit to LA Plastic Surgeons by Dr. Philip Young of Seattle | Bellevue

Saturday, April 10th, 2010

My visit to LA Plastic Surgeons by Dr. Philip Young of Seattle | Bellevue: I had a wonderful time during my visit with Dr Jason Diamond and Dr Davis Nguyen in Los Angeles In March of 2010.  I was also originally going to see Dr Ellenbogen but choose instead the other two surgeons.  During my visit I saw 2 rhinoplasties, a facelift, necklift, premaxillary implant, nasal reconstruction, browlift, fat injections, upper and lower blepharoplasties, and chin implant.  Dr Nguyen is actually a good friend of mine so it was nice to see him in action once more.  I always try to visit surgeons where ever I go to try to learn something new.  You shouldn’t live life as if you were on an island.  My feeling is that you can always learn something new from anybody no matter how smart or not as smart they are.  I had a great time visting Dr Diamond and I really enjoyed getting to know him better as well.  Everybody does things and procedures differently.  With all the hours of experience that each person gains on their own is valuable experience that you can learn from others.  This allows me to continually improve.  I think visiting surgeons is a neccessity.  It is likely more important than the various meetings that we go to as facial plastic surgeons. Continual medical education are recorded as hourly credits that you can earn when you go the meetings held by your specialty.  For me my academy is called the American Academy of Facial Plastic and Reconstructive Surgery.  I try to attend a meeting every year to continually learn.

Thanks for reading, Dr Young

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

Posted in My Journey to Find and Attain Beauty | Comments Off on My visit to LA Plastic Surgeons by Dr. Philip Young of Seattle | Bellevue

Deep Plane facelift versus traditional Facelift by Dr. Philip Young of Bellevue | Seattle

Thursday, April 8th, 2010

Deep Plane facelift versus traditional Facelift by Dr. Philip Young of Bellevue | Seattle:

Question: What facelifts last the longest?  If after 5-10 years do you look the same as you did as if you had nothing done?

Answer: A Deep plane facelift (Dr Young has done over 1200 facelifts) results last the longest of all the facelifts. This type of facelift depends on pulling the muscles of the face rather than the skin. There are many scientific articles that show that the muscle layer is less likely to stretch as opposed to skin. There are also numerous clinical studies in patients that support this finding. I have done over 1200 facelifts and know the difference between the different types of facelifts and have found that the deep plane facelifts last longer, much longer. To answer your question, you should always look better than a twin sister that didn’t have the facelift no matter how many years later.

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 | Comments Off on Deep Plane facelift versus traditional Facelift by Dr. Philip Young of Bellevue | Seattle

Do non surgical cosmetic treatments really work?

Thursday, April 8th, 2010

Options for non surgical cosmetic treatments include: lasers, fillers, sun avoidance, topical skin treatments, etc.  All of these modalities have proven to show improvements in a person’s aesthetics.  Lasers can non surgically remove sun spots, tighten your skin, reduce vascularity and red spots, improve skin texture.  Fillers, can fill volume loss in your face which is actually the culprit of most of the aging that we experience as the years go by.  Sun avoidance decreases the aging of your skin that occurs when your skin is exposed to sun.  The UVA and UVB light can cause DNA mutations in your skin cells that cause aging and also can lead to skin cancer.  Skin treatments which can include microdermabrasion, topical creams, facials, chemical peels that can be done in office and at home can all lead to skin rejuvenation.  Skin treatments can tighten your skin to a degree, decrease unwanted pigmentation, speed skin turnover to rejuvenate your skin on a daily basis and prepare you for significant treatments.

Another in between option is the YoungVitalizer (Dr Young who is in Bellevue, Washington discovered the YoungVitalizer).  This is a procedure that I invented that entails volumizing your face with your own tissue. As we age we change from a grape to a raisin and using your own tissues to volumize your face can make your face look more like a grape instead of a raisin with the wrinkles and loss of the curves.  Most traditional procedures change the aged raisin to a smaller raisin.  You end up, often times, looking like someone else instead of the youthful grape you used to look like when you were younger.

Thanks for reading, Dr Young

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

Posted in Fat Transfer / Fat Injections, Fillers / Facial Fillers, Intense Pulse Light, Laser Resurfacing, Perlane, Radiesse, Restylane, YoungVolumizer | Comments Off on Do non surgical cosmetic treatments really work?

What is the recovery for Asian Blepharoplasty?

Thursday, April 8th, 2010

Recovery from Asian Blepharoplasty (Dr Young is in Seattle Washington) varies and depends on the patient. Generally, the recover takes a week or so. The swelling in the eyes can sometimes take longer to get over depending on your genetics, likelihood of bleeding, your bodies inherent healing properties, etc. Recovery is typically longer than standard blepharoplasty. With Asian blepharoplasty, you have to get to a deeper level in order to recreate the crease. This extra dissection can lead to more swelling, bruising, etc. Techniques to increase the longevity of your crease can add to the healing. But the benefit is that your crease will last longer. I have techniques that make the crease last longer. You can read my blog to find out more about how I do the Asian Blepharoplasty. Another general common understanding of wound healing is that you usually get 60% of your healing the first 6 weeks.  You get 80% at 6 months.  You have 89% of the healing by 2 years and then it tapers off after that.  Look forward to hearing from 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 Asian Cosmetic Surgery, Asian Double Eyelid Surgery / Asian Eyelid Surgery, Blepharoplasty / Eyelift / Eye Lift / Dark Circles / Eye Bags | Comments Off on What is the recovery for Asian Blepharoplasty?

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