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Why do I like Dr Park’s Z epicanthoplasty?

Friday, March 5th, 2010

So when we are talking about the z epicanthoplasty (Dr Young specializes in Asian Eyelid and Facial Plastic Surgery in Bellevue, WA), we are talking about reducing or rearranging the skin that is in the inside portion of the eyelids.  This is the skin that covers the eye in the middle part of the eye.  This extra skin is called the epicanthal fold.  What happens when an Asian Blepharoplasty is performed, the tension created from a higher eyelid crease is placed on the epicanthal fold and a round eye deformity can occur.  The epicanthoplasty widens the eye in the inside part of the eye and ultimately it makes the whole eye look bigger.  The Z epicanthoplasty is unique in that it uses only the eyelid skin and is less prone to scarring.  Older techniques traversed onto the thick nasal skin.  This lead to more tension and more scarring. Keeping all the incisions in the thin eyelid skin prevents much scarring and keeps it too a minimum.  Scarring is unavoidable whenever an incision is made but this can be controlled so that the scarring is barely visible.  The beauty of the Z epicanthoplasty is also that the landmarks that this technique uses is consistent, simple and reproducible. Other techniques are very arbitrary.  The Z epicanthoplasty is also easily incorporated into the upper eyelid skin incision and fits naturally into the new crease that is created unlike other epicanthoplasties that may have reproducible landmarks.  You can see my other blogs for the drawings that we use for the Z epicanthoplasty designed by Dr Jung I Park. Here is video on Asian Blepharoplasty and Medial epicanthoplasty.

I hope that helps.

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 | Comments Off on Why do I like Dr Park’s Z epicanthoplasty?

Masseter and Jaw reduction to slim the face with Botox

Thursday, March 4th, 2010

Botox can be used to slim the posterior part of the face through injections that involve the masseter muscle.  This is done in the office.  We can use topicals and ice to make the injections more tolerable.  We basically inject the botox next to the bone and into the masseter / jaw muscles.  The botox weakens the muscle so that it eventually loses some of its bulk.  The botox takes 2 weeks for maximal effect but the volume reduction is different.  The volume reduces most rapidly in the first 1-2 months with the maximum at 3-4 months with slow reduction over the course of a year.  At twelve months, 50% of the volume that was decreased will be regained at this point. I usually tell people to wait at least a month to see how it looks before adding more botox.  The usually starting dose is 20 units.  But I find that it is most effective when 40 units are started for each side.  But the cost of botox can be high so usually people like to start at 20 units on each side.  Many plastic surgeons price botox less when more is put in.  When you put in 80 or more the price is usually around 11-12 dollars per unit.  Botox in the masseter can decrease the prominence of the jaw muscles so that the lower part of the face looks more slim and this can give the female face a more attractive appearance.  A larger lower third is relatively a musculine trait and less feminine.  Botox in the jaws and masseter muscle can also help some tension headaches that are due to muscle overactivity and temporal mandibular joint disorders.  People who have night time teeth grinding / clenching can have bad headaches.  Botox in the jaws is needed less frequently than the facial muscles for other cosmetic reasons.  Some people can get away with doing botox to the jaws on a yearly basis.

I hope that helps.

Thanks for reading, Dr Young

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

Posted in Jaw reshaping / Jaw Implants / Jaw Augmentation, Procedures | Comments Off on Masseter and Jaw reduction to slim the face with Botox

Facelift for Acne Scarring and other options by Dr. Philip Young of Bellevue | Seattle:

Wednesday, March 3rd, 2010

Facelift for Acne Scarring and other options by Dr. Philip Young of Bellevue | Seattle:

Question: Is a facelift the best option for acne scarring? What other options do I have?

Answer: A Facelift is not the first option but I have noticed improvement in Acne Scarring from this procedure.  I personally have many patients that have noticed a significant improvement on their acne scarring  from a facelift procedure.  Is the facelift a procedure that is usually recommended to a person to improve their acne scars? The answer is “no”.  But I usually present all options to the patient.  Among these options include laser resurfacing, chemical peels, dermabrasion, dermasanding, fillers, fat injections, and excisional techniques.  It depends on how your scars look like.  If you have alot of deep ice pick scars you may need some excisions to completely remove them.  Of course if they are everywhere you might have to pick and choose which ones to excise or cut out.  This excisional approach is usually followed by some resurfacing.  I usually prefer to excise and then resurface the areas at the earliest 6-8 weeks.  One important point to remember is that the goal is improvement.  Your skin is probably not going to ever look like your skin when you were a baby of course. But we can make it better!  Fat injections and fillers can be used to break up the scarring that sometimes holding the skin down to the deeper layers.  This often causes the scars to be held down.  Fat injections is the best way to soften up the adhesions of scarring to allow the skin to come away from the deeper scarring. Here is a live demonstration of fat injections being done in the face (Dr Young is a fat injections specialist from Seattle, Washington). Fillers can also do this, but less well.  Here is a live demonstration video of an Acne Treatment Procedure.

I hope that helps.

Thanks for reading,

Dr Young

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

Posted in Acne Scar Treatment, Chemical Peels, Dermatology, Facelift / Face Lift / S lift / Mini Lift / Weekend Face Lift / Quick Lift / Image Lift, Fat Transfer / Fat Injections, Fillers / Facial Fillers, Laser Resurfacing, YoungVolumizer | Comments Off on Facelift for Acne Scarring and other options by Dr. Philip Young of Bellevue | Seattle:

What is the typical nose job recovery? How long do I need before I can go back to work?

Monday, March 1st, 2010

Rhinoplasty (Philip Young MD, Seattle / Bellevue WA) generally takes about a week recovery but subtle swelling can last for quite sometime.  And usually we say most people can go back to work in one week. Most of the swelling and bruising usually takes about a week to resolve. Sometimes the recovery is less and sometimes more depending on the person. It also depends on what was done.  If tip surgery only was done the recovery is a little faster.  But reduction of the tip can take a long time for the subtle swelling to go down.  The finer tip curves and smaller size can take months to go down and this can continue for up to 2 years or more.  When you break the nasal bones, this action can create more bruising and swelling that could prolong the recovery to more than a week.  In general, I tell patients that they should get 60% of their healing at 6 weeks, 80% at 6 months, and 88% at 2 years and it tapers off after that.  Major changes to the nose does take a little time to be fully realized in the nose.  The subtle changes over the years will show continued improvement.  This is good in the way, because people will not notice the big changes initially and the more subtle changes will slowly occur so that people will not be shocked at the major changes that can happen in your nose and its appearance.

I hope that helps.

Thanks for reading, Dr Young

Dr Young specializes in Facial Cosmetic 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 What is the typical nose job recovery? How long do I need before I can go back to work?

Double Chin (Necklift) and Droopy Cheek (midface | Facelift) Appearance Cost by Dr. Philip Young of Bellevue | Seattle:

Monday, March 1st, 2010

Double Chin (Necklift) and Droopy Cheek (midface | Facelift) Appearance Cost by Dr. Philip Young of Bellevue | Seattle:

Question: What is the cost to improve the double chin and droopy cheek appearance.

Answer: The pricing on this varies depending on location and who you are seeing.  Some doctors have a better reputation and will charge a lot more for their services.  This reputation is usually based on results and word of mouth.  The pricing that is mentioned above will usually not include other fees assessed for anesthesia who have their own fees for these procedures and they usually are based on the time it takes to do the procedures.

The procedures that will help each area will include the necklift (Dr Philip Young of Bellevue, WA) and facelift for the double chin area. Droopy cheeks can be addressed by midface lifts, and deep plane facelift Bellevue area.  My personal opinion is that droopy cheeks are best augmented by volume and I prefer fat injections and the YoungVitalizer for this particular issue.

I hope that helps.

Thanks for reading, Dr Young

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

Come visit us at www.drphilipyoung.com.

Posted in Facelift / Face Lift / S lift / Mini Lift / Weekend Face Lift / Quick Lift / Image Lift, Fat Transfer / Fat Injections, Necklift / Neck Lift / Platysmaplasty / Turkey Gobblers / Neck Bands, YoungVolumizer | Comments Off on Double Chin (Necklift) and Droopy Cheek (midface | Facelift) Appearance Cost by Dr. Philip Young of Bellevue | Seattle:

Facelift Necklift Less than Perfect Outcomes and other Forms of Necklifting by Dr. Philip Young of Bellevue | Seattle:

Monday, March 1st, 2010

Facelift Necklift Less than Perfect Outcomes and other Forms of Necklifting by Dr. Philip Young of Bellevue | Seattle:

Question: I had a facelift and necklift a year ago and it hasn’t turned out the way I envisioned it would be. Is there another form of a neck lift?

Answer: There are many different ways to do Neck lifts and facelifts (Dr Young Bellevue, near Seattle Washington). It really depends on how your surgeon did your lift.  There are a lot of shortcuts out there and if you didn’t have a really extensive neck lift you are likely going to have some recurrence.  I have done over 1200 face and neck lifts and I know that to really address the neck you need to do direct work there.  I prefer to do a corset platysmaplasty.  You can go and read about this in more detail in my other blogs.  But you really have to tighten the neck under the chin area in order to treat the laxity in the neck skin and muscles.  Also, manytimes, it is necessary to go under the neck muscles (platysma) in order to treat the fat underneath and also the muscles under the chin may need some resecting to really improve the area more.  Current face and neck lifts that are marketed out there just take too many shortcuts to tighten the neck. Although they take less long to do, they just don’t address the neck sufficiently.  You can send a picture to me and I can take a look at your neck and what you are worried about. Here is a video on a neck lift:

I hope that helps.

Thanks for reading, Dr Young

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

Posted in Necklift / Neck Lift / Platysmaplasty / Turkey Gobblers / Neck Bands | Comments Off on Facelift Necklift Less than Perfect Outcomes and other Forms of Necklifting by Dr. Philip Young of Bellevue | Seattle:

Reoccuring Jowls 3 years after facelift and what is a Thread Lift By Dr. Philip Young Bellevue | Seattle:

Thursday, February 25th, 2010

Reoccuring Jowls 3 years after facelift and what is a Thread Lift By Dr. Philip Young Bellevue | Seattle:

Question: What can be done for reoccuring jowls after having a facelift 3 years ago? What about the thread lift?

Answer: A Chin Implant Reshaping or Fillers / Fat injections (Dr Philip Young Seattle Washington)could help the looseness in the jowls.  The jowls occur for a number of different reasons. If you read my other blogs you can find pictures that illustrate jowls.  What happens is that when you lose volume in the face, especially the cheeks and jawline area along with volume around the mouth, the jowls become more prominent.  As an example, pinch the skin by your upper cheeks just inferior and lateral to the eye.  Notice as you do this, that the jowls begin to rise a little bit.  Now in front of your jowls is a depression and volume loss call the prejowl area.  This area along the jawline and closer to the lips and in front of the marionette lines can be filled in as well.  Also along the jaw in front of the ear can also be filled in and this can have an effect on the jowls decreasing.  Sometimes people fill in the prejowl area with fillers and fat injections to reduce the appearance of the jowls through a camouflage type of correction. In terms of volumizing with fillers, you can also use fat injections for the same thing and you can add more volume with fat than you can, a lot of times, than with filler.  Fillers are quite a bit more expensive than fat for filling in volumes.  Sculptra is another option in between fat and fillers. Sculptra can last over 2 years and some are finding more than that.  Other options for the jowls include direct liposuction of the jowl area.  Thread lifts, in my opinion, don’t work. They pull on the skin for a time being but relax and most of the time I don’t think you get any long term improvement.  The only time you get long term improvement is when you turn the thread lift into basically a facelift done in many traditional ways. Here is a facelift consult to help you prepare before a facelift consult:

I hope that helps.

Thanks for reading, Dr Young

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

Posted in Chin Surgery, Facelift / Face Lift / S lift / Mini Lift / Weekend Face Lift / Quick Lift / Image Lift, Fat Transfer / Fat Injections, Fillers / Facial Fillers, YoungVolumizer | Comments Off on Reoccuring Jowls 3 years after facelift and what is a Thread Lift By Dr. Philip Young Bellevue | Seattle:

Lip scars around the border of my lips are hard, sensitive and I have discomfort when I smile and talk, etc. What are some options to make this situation better?

Thursday, February 25th, 2010

Steroid injections and possibly fat injections could soften the scars up during scar revision (Doctor Philip Young Seattle Washington) (scar improvement, cosmetic scar surgery, plastic surgery of scars).  It sounds like the main reason for your questions is the feeling of the scars and not the actually appearance.  Scar revision for appearance would be a totally different thing.  I think that steroids would be something that could soften up the scars. It may take a couple of treatments to get the right effect.  I usually do injections every 6-10 weeks.  There are risks with steroid injections like poor wound healing, muscle and bone loss, hormonal changes, water retention, weight gain, hair growth, changes in your appearance, psychiatric issues, change in appetite, etc that you should be aware of.  But these are associated with more long term risks that you get when you ingest steroids for long periods of time.  Also fat injections are great to break up scar contracture and also repair the area, although this would depend on how it looked. Fat brings soft feeling tissue to the area and can also break up the scars and the tough tissue within the scars.  This will require some knowledge on how to use certain instruments to get this effect on the part of your surgeon.

If you didn’t like the way the scars looked then some type of scar revision would be possible.  You can excise the scars out with a new closure of the incision.  Laser resurfacing can be another option to improve the surface quality of the scars.

I hope that helps.

Thanks for reading, Dr Young

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

Posted in Fat Transfer / Fat Injections, Lip Augmentation / Lip Fillers / Lip Injections / Lip Reduction / Lip Grafts / Lip Advancements / Fat Injections of the Lip, Scar Removal / scar reduction / scar revision / scar treatment | Comments Off on Lip scars around the border of my lips are hard, sensitive and I have discomfort when I smile and talk, etc. What are some options to make this situation better?

How do you get naturally looking lips and what are some tips for natural looking lip plumping?

Wednesday, February 24th, 2010

Aesthetics are key to understanding the lips and how to make them beautiful through lip augmentation (Dr Young Lip Enhancement in his Bellevue Office). Aesthetics in the face is really understanding facial beauty and this is central to the process of making one’s face and lips beautiful.  Previous theories do not have a good explanation for how a lip should appear in its most beautiful state.  I would invite you to visit my blog and website to see more answers to this.  But I discovered a new theory on facial aesthetics called the Circles of Prominence that I think answers some of these questions. To me the lip is assessed by the highlights that it creates. If you look at someone next to you, you will notice that all the light hits the lower lips.  This is very important.  You retina is highly sensitive to light and dark.  The highlights that the lower lip creates attracts a lot of attention and it is the lower lip that is the center of attention in the mouth area. The lower lip should be the same height as the iris and the puckering that it creates should be 3 iris widths.  Essentiially the lip emulates the shape of the eye, usually in reverse form.  The lower lip should be half the height of the lower lip and the puckering of the upper lip should be centered and should be one iris width in width and again one half an iris width in height.  The goals of augmentation should be to reach this.  This is the reason that many hollywood people who get their upper lips too big start to look odd.  You don’t know why inherently, but your brain does.  And the reasons I stipulated above explains why your brain feels the way it does.  Whether you use temporary fillers, like restylane, juvederm, perlane or more permanent options.  These aesthetic goals you should direct your surgeon in how to augment your lips.  More permanent options include fat injections, vy advancements, lip lifts, or silicone solid implants, like surgisil, or permalip.

I hope that helps.

Thanks for reading, Dr Young

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

Posted in Fat Transfer / Fat Injections, Fillers / Facial Fillers, Lip Augmentation / Lip Fillers / Lip Injections / Lip Reduction / Lip Grafts / Lip Advancements / Fat Injections of the Lip, YoungVolumizer | Comments Off on How do you get naturally looking lips and what are some tips for natural looking lip plumping?

Can Facial Nerve Damage occur with Rhinoplasty and Chin Reduction Surgery?

Wednesday, February 24th, 2010

Facial Nerve Damage from Rhinoplasty (Aesthetic Facial Plastic Surgery, Dr Young Bellevue) and Chin Reduction Surgery (Philip Young MD, Bellevue, WA) is extremely rare.  From Rhinoplasty, Facial Nerve Damage would be something that you could report in the literature because it is extremely rare.  I have never heard of that ever.  So you worry about Rhinoplasty causing that should be lessened.  Chin Reduction surgery is a viable concern. When you do this type of surgery, you have to elevate the chin area.  Superficial to this elevation, you do have nerve fibers from the facial nerve that traverse this area.  If one were not in the right plane you could damage this nerve although this is still pretty rare.  Also with Chin reduction surgery, you need to tailor the skin envelope to accomodate the smaller chin after reducing the bone volume.  this tailoring can injure the nerve. One thing to remember is that, at that point you are dealing with end fibers of the facial nerve and likely regeneration will occur without any effects if it were to happen.  But more laterally when you do your reduction you need to be careful to stay in the right planes.  That might be too much information.  In general, the risk of facial nerve damage from either procedure is extremely rare!

I hope that helps.

Thanks for reading, Dr Young

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

Posted in Chin Surgery, Rhinoplasty / Nose Surgery / Nose job / Nose Reshaping / Nasal Reshaping | Comments Off on Can Facial Nerve Damage occur with Rhinoplasty and Chin Reduction Surgery?

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