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I am wondering if a brow lift, asian double eyelid crease procedure or a epicanthoplasty in the medial or lateral area would make my eyes look better.

Sunday, March 14th, 2010

This is a question that I answered for a patient:

A double eyelid and a medial epicanthoplasty would be fitting for you. In my opinion and the opinion of many of my colleagues a lateral epicanthoplasty usually leaves something less than desired for many people.  What distinguishes an Asian Eyelid from a caucasian eyelid is usually the medial canthus where an epicanthal fold is present in about 50-80% of Asians.  This has an effect of making the eyes smaller horizontally.  I see the hooded portion in the lateral part of your eye.  However, I believe that if you were to do a double eyelid crease formation that part of your eye would be tacked upward and will be markedly improved.  I do see that you have an extra fold in the medial part of your eye that is called the epicanthus. Because the picture shows that the fold covers that fleshy part of your eye in the middle part I would classify this as a type 3 epicanthal fold. If it was partially covering the fleshy part it would be classified as a type 2.  An epicanthoplasty would open up your eyes horizontally here a great deal.  I don’t think you need a brow lift. I think the distance from eyelid margin and your brows is long enough and a brow lift would make you look surprised. I really think that you need some fat in your eyelid or some type of filler there to volumize this area.  If you look at some pictures of you when your were a child you will see more fullness there where the volume could recreate some youth for you there. As for the lateral epicanthoplasty, you can always do that later but I really don’t think that it will ever enhance your appearance.

I hope that was interesting for you!

Thanks for reading, Dr Young

Dr Young specializes in Facial Cosmetic 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 I am wondering if a brow lift, asian double eyelid crease procedure or a epicanthoplasty in the medial or lateral area would make my eyes look better.

Does Asian Blepharoplasty and Double eyelid Surgery mean the same thing?

Sunday, March 14th, 2010

Asian Blepharoplasty and Double Eyelid Surgery is essentially the same thing.  Double eyelid surgery specifically means creating the crease in the upper eyelid.  Now this doesn’t have to be used only on Asians.  Caucasians can have this as well and can lose their double eyelid later on in life due to aging.  So this procedure of creating a double eyelid can be used for this group as well.  Most of the time when Asians want an eyelift they usually come in to discuss creating the double eyelid crease and in this instance when you are talking about an Asian Blepharoplasty, creating the double eyelid crease is usually a part of this procedure.  Sometimes though in older Asian patients who have a double eyelid already, Asian Blepharoplasty could just be a regular blepharoplasty that is applied to all races and could mean that a double eyelid crease creation may not be necessarily a part of the eyelift. Here is video on Asian Blepharoplasty and Medial epicanthoplasty.

I hope that was interesting for you!

Thanks for reading, Dr Young

Dr Young specializes in Facial Cosmetic 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 Does Asian Blepharoplasty and Double eyelid Surgery mean the same thing?

I have small Asian eyes and is wondering if a double eyelid procedure will make my eyes look bigger because I don’t think it will.

Sunday, March 14th, 2010

This is a question I answered for someone who was interested in a double eyelid surgery for Asian eyes:

The double eyelid procedure will help to make your eyes look bigger. Based on the picture, it doesn’t look like you have any crease. Sometimes skin is allowed to override your eyelid margin which can make the eye opening look smaller.  Also by creating an eyelid crease, the shadowing contributes to the appearance that your eyes are bigger by creating the shadow the meets up with the dark part of your eyes.  Another procedure that can help open up your eyes is the medial epicanthoplasty that is done in the middle part of the eyes that will open the eyes up horizontally.  Lastly, you can do a procedure that tightens up the muscle that opens up your eyes but this is advanced, is not standardized or universally accepted to open up your eyes. Here is video on Asian Blepharoplasty and Medial epicanthoplasty.

I hope that was interesting for you!

Thanks for reading, Dr Young

Dr Young specializes in Facial Cosmetic 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 I have small Asian eyes and is wondering if a double eyelid procedure will make my eyes look bigger because I don’t think it will.

I would like my crease to be higher but I’ve already had a double eyelid operation done for my Asian Eyes? Also I would like the corner’s of my eyes operated on for a larger looking eye.

Wednesday, March 10th, 2010

Double eyelid crease formation and epicanthoplasty can be done as a revision.  There are a few nuances that need to be considered in this situation.  Making a higher crease, will or may entail a higher incision and fixation at a higher point with also more skin excision.  It is usually easier than making a higher crease smaller.  When you mention opening the corner of your eyes, do you mean the inner or outer corners.  The inner corners are more likely the area that will open your eyes more than the outer corners from a congenital standpoint.  Asian epicanthal folds are in the medial or inner corners of the eyes. This is what distinguishes Asians from Caucasians in many Asian people and not the outer corner of the eyes.  I have seen many results from the outer corners being cut and they don’t make as much difference as when the procedure in the inner part of the eyes are done.  One thing to remember is that most Asian appearing eyes have a crease that is 3mm or less when the eyes are open.  When they are larger they begin to take on more of a western caucasian look.  There are studies that validate this assertion in the literature.  Here is video on Asian Blepharoplasty and Medial epicanthoplasty.

Thanks for reading, Dr Young

Dr Young specializes in Facial Cosmetic 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 I would like my crease to be higher but I’ve already had a double eyelid operation done for my Asian Eyes? Also I would like the corner’s of my eyes operated on for a larger looking eye.

What are the best sutures to use to reduce scarring?

Wednesday, March 10th, 2010

The are a couple of things I adhere to in order to reduce scarring.  Sometimes scarring is hard to avoid when the person’s genetics are predisposing them to scarring.  But we take every effort to reduce scarring.  First we try to avoid tension to the skin closure.  This is done by decreasing the tension on the surface by cinching the deeper structures together.  Usually the goal is to have the skin be a little puckered in the above the rest of the areas.  This reduces tension the part of the incision that is most seen on the surface.  We also take face sutures out at 5-6 days and eye sutures out sometimes a little earlier depending on what I’m trying to accomplish.  The average is usually 7 days.  The reason why this is important is that the longer you leave the sutures in, the more train tracking or marks are left on the surface which can lead to more scarring and more marks on the skin indicating that an incision was made previously. So I err on the earlier side at 5-6 days.

We also use monofiliment sutures, like 5-0 and 6-0 prolene.  Monofiliment (sutures like nylon, ethilon, etc), means that the sutures is made out of one strand of suture material.  Polyfilament means that the sutures is made out of more than one strand.  When the suture is made out of more than one strand, the is an increase in the interstitial spaces between the strands.  This allows bacteria to hide from our white infection fighting cells and the results can be infection, more inflammation, and ultimately more scarring.  Prolene is not absorbed by the body and needs to be taken out.  It creates less inflammation than absorbable sutures (like vicryl, fast absorbing gut, chromic gut, biosyn, polysorb, etc) and thus can avoid more scarring.  There are many studies that support this notion on a clinical level (on the level of patient outcomes). Here is a video on Scar Revision.

These same principles are what I do for Scar Revision and scar improvement procedures.

Thanks for reading, Dr Young

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

Posted in Procedures, Scar Removal / scar reduction / scar revision / scar treatment | Comments Off on What are the best sutures to use to reduce scarring?

Are you the right candidate for Aesthetic Facial Plastic Surgery and Dr Philip Young?

Sunday, March 7th, 2010

This is a great question. We have many people that come to us to have facial rejuvenation.  One thing that people might not know is that we are selective in the clients we choose to take on.  You have to be the right  candidate.  There are many people that I actually turn away from our office.  First, you have to possess the right anatomy for the procedures that you are interested in.  If someone were to come to me to have their eyes done and they look great to me. This person would not be a candidate for a procedure.

You have to have the right mind frame or mental status to be a good candidate for facial cosmetic surgery. Here is another example, I recently had a lady that was interested in fat grafting to her face.  She researched all across the country.  She  would write me all the time detailing to me where she would like the fat taken from and where to put it in.  She went into great detail in regards to this.  I would offer my advice but she seemed to know more about fat grafting than me according to her opinion.   I had a feeling that she might not trust what I said.  In addition to this, she didn’t get along with my staff and this was unusual.  With other additional pieces of information, I knew intuitively as well as objectively that she was not a good candidate.  We had to tell her that we couldn’t help her.

Another client had surgery in Korea, and she was fixated on the incision under her eyes that was used for a lower eyelid lift.  I carefully examined her and didn’t notice the particular issue to the degree that the client had emphasized.  She felt that her whole life was ruined because of this incision under her eye.  Now, if this incision was bad and left a significant scar, I would or might tend to see where this patient was coming from.  The scar for the lower eyelid lift was not significant at all.  In face, even her husband thought that it looked good and he suggested to her that she see a psychiatrist.  I couldn’t have agreed with someone more and I told the husband that I agreed with him too.  This patient also was seen as someone who couldn’t benefit from our services and we had to write her a letter telling her that we would not be able to offer any of our services to her.

We probably get at least one person a month like that.  Although, we would like to help everybody.  You have to be the right candidate, and we choose carefully.

Thanks for reading, Dr Young

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

Posted in Procedures | Comments Off on Are you the right candidate for Aesthetic Facial Plastic Surgery and Dr Philip Young?

What is the muscle that causes crows feet?

Sunday, March 7th, 2010

The muscles that cause crows feet are the orbicularis oculi and the smiling muscles: levator labii superioris, zygomaticus major and minor.  Here is a picture of these facial muscles.  When we try to improve crows feet with botox, these are some of the muscles that we try to weaken to decrease the formation of wrinkles.  Botox is injected in the sides of your eyes in the skin to weaken these muscles.  By doing this, we make the muscles weaker so they are less likely to form these dynamic wrinkles.  Dynamic wrinkles are the wrinkles that show up when you move the muscles of your face.  They are more pronounced when you move your facial muscles.  Static wrinkles are the wrinkles that are so etched in that they are present when you are not moving your facial muscles of expression.  Dynamic wrinkles are mostly effected by the actions of botox.  Over time, with continued use of botox, the static wrinkles can become more improved.  This is done because with botox, eventually allows the skin to remodel and reduce the static wrinkles.  This action of improving the static wrinkles however takes a long time and requires regular and consistent use of botox.

I hope that was interesting for you!

Thanks for reading, Dr Young

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

Posted in Botox, Dysport, Botulinum, Dermatology, Fat Transfer / Fat Injections, Fillers / Facial Fillers, Wrinkle Treatment, YoungVolumizer | Comments Off on What is the muscle that causes crows feet?

What are the options for Crows feet?

Saturday, March 6th, 2010

Crows feet are due to the eye muscles that surround the eye. These muscles are meant to close the eye, to blink, to protect the eye, etc.  When doing these movements, they can affect the skin around the sides of the eyes.  What results with this movement are the wrinkles that are commonly called the crowsfeet.  Botox is usually the way that people get some relief for them.  It usually takes about 8 – 12 units of botox on each side and the costs are around 10-16 dollars per unit of botox.  Other options include laser resurfacing, fillers, or fat injections for these wrinkles.

Fat injections and fillers function to do the same thing. When we age we lose volume in the skin and in the whole face in general.  What this does is bring the skin closer to the muscles of our face.  When we were young, there was a greater distance from the muscles of facial expression and the skin.  This distance was occupied by our skins fat and connective tissue.  When you smiled when you were young, the muscles tended to glide under your skin.  The fat in the skin above the muscles of facial expression allowed the skin to slide.  This exact phenomenon occurs in multiple areas of your body.  It is essential for muscle movement in fact.   As we age, the muscles of facial expression become closer to the skin, when we progressively lose the fat and connective tissue within and under the skin.  Hence, progressively when we smile are muscles of facial expression begin to exert more effects on the skin and these are manifested through wrinkling when we smile.  Through fat injections, fillers, or the YoungVolumizer, this layer of fat between the skin and muscles is increased and the muscles of facial expression have less of a wrinkling effect on the skin.

Resurfacing through chemical peels, lasers, or dermasanding / dermabrasion essentially takes away the top layers of the skin to allow skin cells deep within our hair follicles, glands etc to “resurface” the skin.  In the process of the procedure, we remove wrinkles, create a new layer of collagen underneath the skin, remove unwanted pigmenation and DNA damage, remove precancerous or cancerous cells, etc.  The skin then becomes renewed with healthier cells, you have less sun spots, wrinkles and the tone and texture of your skin is rejuvenated.

I hope that was interesting for you!

Thanks for reading, Dr Young

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

Posted in Botox, Dysport, Botulinum, Fat Transfer / Fat Injections, Fillers / Facial Fillers, Skin Care / Intense Pulse Light, Wrinkle Treatment, YoungVolumizer | Comments Off on What are the options for Crows feet?

Browlifts in someone with a High Forehead

Saturday, March 6th, 2010

Browlifts (Dr Philip Young Seattle Washington) are usually done through an incision behind the hairline in traditional methods.  This allows the eyebrows to be elevated and the muscles in between the eye to be resected or modified to keep the eyebrows from creating the “elevens” wrinkles or the wrinkles in between the eyes that create an angry look.  Resecting the muscle makes it so that making an angry look becomes much harder.  The incision behind the hairline can be used to elevate the eyebrows but this often can lead to an even higher forehead or more posterior hairline that is sometimes unwanted in someone who already has a high forehead.  This can be avoided by making the incision within the front of the hairline so the hairline is not pulled back.  The minor drawback is the incision within the front of the hairline.  But the incision can be adjusted so that the hair can grow through the incision to hide it better.  Limited incision browlifts can also be done to avoid a long incision across the scalp but these tend to also elevate the hairline.

I hope that was interesting for you!

Thanks for reading, Dr Young

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

Posted in Browlift / Eyebrow Lift / Brow Lift | Comments Off on Browlifts in someone with a High Forehead

High Hairline and options for Improving this Masculine Look.

Saturday, March 6th, 2010

If you have a high forehead there are options for you.  Lowering your hairline is an option that can be done.  Hair transplants are one way of doing this.  This approach is highly technique dependent and requires a lot of time to do this.  Another way of doing this is to lower the hairline through a procedure that requires an incision within the front of the hairline that is a variation of a Brow Lift.  Then what is needed in elevation of the hair posteriorly and a little bit anteriorly.  Release of the scalp’s tension is then sometimes needed to allow the hairline to come forward.  Anchoring the hairline in a lower position is then done by fixing the hairline to the bone of the forehead. A browlift can also be done in concurrence if needed.  Further elevation done to the orbital bones is required for a browlift and after the release of the eyebrows you can then elevate the eyebrows to the desired position.  A look at myFacial Beautycan help one to figure out how high the forehead should be.

I hope that was interesting for you!

Thanks for reading, Dr Young

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

Posted in Browlift / Eyebrow Lift / Brow Lift, Transgender or Facial Feminization / MasculinizationSurgery | Comments Off on High Hairline and options for Improving this Masculine Look.

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