Author Archive

« Older Entries
Newer Entries »

How long should I wait after an eyelift / blepharoplasty procedure to wear contacts?

Tuesday, February 23rd, 2010

This depends on the particular eyelift / blepharoplasty (Dr Young Seattle, Washington) surgery you are getting. In general, I tell people to wait to wear contacts two weeks after the procedure to allow the incisions to heal and to give you time for any discomfort from the procedure to be more tolerable.  The discomfort can be an issue with contacts when you have to stretch your eyelids to put them in.  It usually happens that at 2 weeks, your discomfort from the procedure is also much improved for you to put your contacts in as well.

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 Blepharoplasty / Eyelift / Eye Lift / Dark Circles / Eye Bags | Comments Off on How long should I wait after an eyelift / blepharoplasty procedure to wear contacts?

What type of anesthesia can or should you do with otoplasty, ear shaping surgery?

Tuesday, February 23rd, 2010

The anesthesia you choose can be up to you for otoplasty / ear reshaping surgery (Dr Young Seattle).  Your physician should have multiple choices for you to choose from.  We have every available method for someone to choose but one thing to realize is that the more anesthesia you choose many times the more expensive.  Otoplasty (or ear shaping, ear reshaping, ear pinning, ear plastic surgery, ear cosmetic surgery, ) is a local procedure which, in my opinion, can be done under local anesthesia without any sedation.  I usually do suggest iv sedation to make people feel more comfortable.  So here are the different levels:

1. no sedation, just local injections of anesthesia to make the area totally numb. One major drawback is the painful injections to make the area numb. Although, I employ measure to make the area more easily tolerable to injections by using a vibrating apparatus.

2.  oral sedation with local injections. Here we use oral valium (a sedative), percocet (a pain medication), phenergan (an anti nausea medication). To help with pain, to make a patient less aware, and to prevent nausea that are cause by the valium and percocet.

3. Iv sedation with our registered nurse with local injections.  Intravenous sedation, or iv sedation, can help even more with relaxing a patient.  Also it can act a lot faster than oral sedatives which take a while longer to move and get absorbed by the gastrointestinal system. Also if you get nauseous during the case, the iv is great to adminster drugs quickly to help.  There are also other benefits with iv sedation for blood pressure.

4. Iv sedation with a certified registered nurse anesthetist (crna) with local injections. The difference between 3 and 4 is that the crna here can give you stronger medications that can really make you drowsy.  The Crna however is much more expensive and this can be a factor in people’s decision making

5. The next level is general anesthesia done in a surgery center and hospital.  This is where the patient is completely sedated and will require a breathing tube.  General anesthesia is little more riskier, can place more stress on the body and you will need to be more fit to undergo this anesthesia and your doctor will be more inclined to get a medical clearance to see if you can tolerate this type.  Also this type of procedure will be much more expensive for the patient

In general, I think that the options from 1-3 are plenty for otoplasty. But this will depend on the patient’s choice.

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 Otoplasty / Ear Reshaping / Ear Shaping, Procedures | Comments Off on What type of anesthesia can or should you do with otoplasty, ear shaping surgery?

Chemical peels can be uncomfortable but depends on the depth of peels.

Tuesday, February 23rd, 2010

Chemical peel (Dr Young’s Chemical Peels) can be uncomfortable but depends on the depth of peels.  Superficial peels can even be uncomfortable and many times I will use a hand held fan in my practice.  The other doctors mention that chemical peels don’t really hurt.  I would tend to disagree based on my experience.  Jessner’s peels are superficial but they are uncomfortable but tolerable.  Anything using tca 20% or more will cause discomfort that will need oral sedation or iv sedation in my opinion for my patients comfort along with topical anesthesia.  Glycolic peels are more superficial than Jessner’s peels but they are still uncomfortable in my experience. I’ve done these myself on myself.  So make sure to ask your doctor what they do to make you feel more comfortable.  There are things that can be done!

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 Chemical Peels | Comments Off on Chemical peels can be uncomfortable but depends on the depth of peels.

Genioplasty or Chin Implant to move the chin forward without increasing the vertical height.

Tuesday, February 23rd, 2010

Genioplasty or Chin Implant (Dr Philip Young, Seattle) to move the chin forward without increasing the vertical height during chin cosmetic surgery (or chin plastic surgery, chin enhancement surgery).  This can be done but can be tricky.  Anytime you project the chin forward, because the chin is usually angled in a inferior direction and not horizontally straight (you can see this by using two mirrors and looking at your side profile), Any lengthening of the chin will cause some vertical lengthening.  You can avoid this by making some adjustments to the chin implant, by tailoring the bottom of the chin implant.  The other more advanced way is to reduce the vertical chin height by taking the bone down in the vertical dimension and then augmenting it more horizontally.  In general genioplasty is favored among plastic surgeons due to the easier procedural steps, less complications, and less operation time to name just a few reasons.

I hope that is helpful.

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 | Comments Off on Genioplasty or Chin Implant to move the chin forward without increasing the vertical height.

Fillers and Fat injections for Cheek Augmentation by Dr. Philip Young of Bellevue | Seattle:

Tuesday, February 23rd, 2010

Fillers and Fat injections for Cheek Augmentation by Dr. Philip Young of Bellevue | Seattle:

Fillers Upper Lower Eyelid Eyelift

Radiesse is made of Calcium Hydroxyapatite which is the exact molecule that is like our bones except without the cells and other tissues like collagen, blood vessels etc.  It is very compatible with our bodies.  Studies done by Radiesse have shown that this product is replaced a little bit by collagen.  Radiesse has been shown to be present after 5 years by biopsy and some of this work has been done in the area of urology and the bladder neck.  It is a stiffer products than the other fillers like restylane, and sculptra.  The product is made up of 30% calcium hydroxyapatite so the rest of the 70% is removed over the first 6 months to a year and the 30% can stay around longer.  Some people seem to metabolize the calcium more quickly and this can decrease the longevity, although this is through my observation and has no scientific analysis to it yet.

Sculptra is made up of poly l lactic acid and is like vicryl suture which is degraded by our body to water and sugar which we can use.  The degradation process is what produces the inflammation that eventually creates collagen, in a controlled scar like fashion.  Results are for at least 2 years and they are finding that it lasts even longer in many instances.  I have a patients whose results have been there for over 5 years.  This inflammation is beneficial in that it produces collagen but on the flip side this inflammation when not controlled can lead to infection although this is very rare.  Although most of the doctors mention bumps, this can be avoided.  I have some techniques that make this much less likely.

Fat injections are a great longer term option.  They are natural. They take on the structure and feel of the tissue they are placed next to.  If they are placed next to bone they will feel like bone and etc.  They can last years, although this depends on the particular person, some results can last 10 years or more. They require no incisions in the face, the discomfort is mucher lower than traditional approaches like facelifts, eyelifts.  They do require a recovery period from the bruising and swelling but is acceptable.  Unlike sculptra and radiesse, fat can be placed closer to the eyelid and lashes.  Whereas these products need to be along the bone under the eye and this is where you can some problems with transitioning the volume from the bone to the eyelid whereas fat can do this transition. You can read my blog for more information.

In terms of transitioning the product to the eyelid wiith radiesse and sculptra, the other alternative is to do transitioning and touchups with restylane, perlane or juvederm when needed. These hyaluronic acids (restylane, perlane, juvederm) can also be used for cheek augmentation but last less long (6 months to a year) than radiesse (year or longer) and sculptra (at least 2 years).

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 Cheek Augmentation, Fat Transfer / Fat Injections, Fillers / Facial Fillers, Radiesse, Sculptra, YoungVolumizer | Comments Off on Fillers and Fat injections for Cheek Augmentation by Dr. Philip Young of Bellevue | Seattle:

How much bandaging do you receive after a facelift? by Dr. Philip Young

Tuesday, February 23rd, 2010

How much bandaging do you receive after a facelift? by Dr. Philip Young

Plastic surgeons vary in terms on how much bandaging they do when they do Facelifts  I personally do not like to rely on bandaging to hold the skin down and prevent fluid accumulation.  When your bandages are too tight you can create a situation where your skin doesn’t get blood flow as easily and readily.  This can put your skin at risk for having problems like skin partially not surviving.  I usually use drains to do this, and they have been scientifically proven over many studies to benefit decreasing blood flow although they haven’t been shown to prevent very large accumulations of bleeding which is often called a hematoma.  I believe that drains are a lot better for the healing from a facelift and do minimal bandaging.  I just use a sticky ace wrap that is 4 inches in width and some gauze pads underneath.  I usually say to wrap 24 hours for the first week or two if they can and then to wrap for the first two months at night.  Pressure from the bandaging can help with healing over this time.  You can do this wrapping for a longer time if you have additional swelling.

Here is a video on Facelifting:

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 our website at www.drphilipyoung.com

Posted in Facelift / Face Lift / S lift / Mini Lift / Weekend Face Lift / Quick Lift / Image Lift | Comments Off on How much bandaging do you receive after a facelift? by Dr. Philip Young

What can you use to fill in the hollows of the face?

Monday, February 22nd, 2010

Fillers and Fat injections (Dr Young does Filler in his Bellevue Office!) can fill in the hollows.  Fillers like restylane, radiesse, perlane, juvederm, can fill in small hollows that are smaller than 1cm squared or  a square area about a 1/3 of an inch.  Fat injections are another more longer term possibility.  Sculptra is a filler made up of suture material that when digested by the body forms collagen for a more longer term solution as well.  The YoungVolumizer is my method of volumizing the face and hollows.  I have a great technique that leads to better fat survival and more long term results.

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, YoungVolumizer | Comments Off on What can you use to fill in the hollows of the face?

What is a revision rhinoplasty and how is it different from a regular rhinoplasty?

Monday, February 22nd, 2010

Revision rhinoplasty is a cosmetic nose shaping procedure done after one has already been done before.  A revision rhinoplasty is just a procedure that is done to improve on the rhinoplasty that was done originally. This occurs at a certain rate with all surgeons.  Many surgeons use this as a gauge to determine how facile they are with rhinoplasties.  The lower rate of revision the better. No surgeon has a 0% rate of revision.  If any surgeon tells you that, he is most definitely not telling the whole truth.  Even the very best rhinoplasty surgeons I know, or at least are the deemed the best by their peers, have a revision rate that doesn’t get much lower than 10%.  Rhinoplasty is a very hard procedure and revisions are a necessary part of the process but vital in ensuring the very best result in the end.

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 a revision rhinoplasty and how is it different from a regular rhinoplasty?

What is the best treatment for laugh lines? Fillers or Botox?

Monday, February 22nd, 2010

Juvederm is commonly used for laughl lines as well as botox.  It is important to know what you mean by laugh lines.  Many refer to these as the lines around the eyes, or crows feet.  Others mean when the say “laugh lines”, the lines around their mouths or nasolabial folds.  I have a blog that defines those areas if you are interested to know the terms.  But the nasolabial folds are the folds that run from the nose along the sides of the mouth. Whereas the lines below the mouth on the sides are commonly refered to as the marionette lines or puppet lines.  The crows feet can be improved by botox and they can also improve the nasolabial folds to some extent.    Fillers like juvederm can also fill in the nasolabial folds, marionette lines and also help with the crows feet.  In order to really understand how they work a visit to a facial plastic surgeon would be helpful.  Now the difference between fillers and botox is that fillers replace volume that is lossed during aging.  When you lose volume there is an excess amount of skin compared to the underlying tissues.  More skin for a set amount of volume leads to more folding of the skin and hence more wrinkles.  Fillers replace that volume and hence fill in the skin and thereby decrease the ability for the face to make wrinkles.  Botox, which is a neuromuscular agent can make the muscles less likely to contract.  Hence they are most beneficial for dynamic wrinkles, or the wrinkles that are caused by muscular activity.

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 Botox, Dysport, Botulinum, Fillers / Facial Fillers, Juvederm, Perlane, Radiesse, Restylane, Wrinkle Treatment | Comments Off on What is the best treatment for laugh lines? Fillers or Botox?

Blepharoplasty / eyelift for a person in there 20’s

Thursday, February 18th, 2010

This is a question that I answered for a person who was thinking of an upper blepharoplasty / eyelift to decrease the puffiness in their upper eyes.  This is how I answered her questions:

This puffiness that you see is really actually what makes you look younger.  I think what you are looking for is a more sculpted look where you have less fat in your eyelids.  This can be done for you but I think you should really think about it before doing so.  You might need to also increase the height of your double eyelid crease so that more of your pretarsal show is present with your eyes open.  I have a blog that discusses pretarsal show with some diagrams if you are interested in reading that.  I don’t really think you have extra skin, I think you have normal puffiness that a young person has.  You can always discuss this in more detail with me during a phone consult if you are interested.  Asians typically have more periorbital eye fullness and fat.  This can give them a more puffy appearance but this is part of their ethnicity.  What you might be interested with what you are asking is more westernization of your eyelid which can be done.

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, Blepharoplasty / Eyelift / Eye Lift / Dark Circles / Eye Bags | Comments Off on Blepharoplasty / eyelift for a person in there 20’s

« Older Entries
Newer Entries »