Archive for the ‘Procedures’ Category

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Neck lift after smart lipo can be done as soon as 3 months but the standard that many follow is 6 months by Dr. Philip Young of Bellevue | Seattle:

Saturday, July 10th, 2010

Neck lift after smart lipo can be done as soon as 3 months but the standard that many follow is 6 months by Dr. Philip Young of Bellevue | Seattle: This is the standard for most all revisions.  6 months allow the tissues to heal.  Prior to this, you can have friable tissue that will bleed more and could lead to more difficult surgery.  Also the 6 month standard allows the person to see more of the final result.  Some people do revisions earlier and as early as 3 months with those risks in mind.  Smart lipo can remove the neck fat and do some tightening, but will not replace what can be done with a traditional neck lift. I like to do my neck lifts using techinques that I developed based on over 1200 neck and facelifts.  I have learned that a lot of what is taught to surgeons doesn’t lead to the best results.  You should go to someone that has a lot of experience doing neck lifts.  Many surgeons take short cuts for many different reasons that don’t benefit you.  A well done neck lift will take up to 3-4 hours to really get right. As you can see in the diagram below, the platysma muscle is the muscle that I tighten to tighten your whole neck.  I sew that muscle in the middle starting just under your chin and then continue down to the base of your neck and then back up again in a corset type manner.  I don’t cut the muscle, which many surgeons do, because I don’t think that it allows the muscle to tighten the whole neck evenly.  Also cutting the muscle can create odd appearances with your neck that don’t always look good.  Also, I elevate the platysma and take out fat under the chin to further help with contouring the neck.  Within this area, I sometimes alter the muscles as well.

Playtysmaplasty | Neck Lift Anatomy

Playtysmaplasty | Neck Lift Anatomy

Posted in Necklift / Neck Lift / Platysmaplasty / Turkey Gobblers / Neck Bands | Comments Off on Neck lift after smart lipo can be done as soon as 3 months but the standard that many follow is 6 months by Dr. Philip Young of Bellevue | Seattle:

Cartilage grafts to reduce the rounding and retracting to your nostrils can be done without making your nose longer looking.

Saturday, July 10th, 2010

There are techniques in rhinoplasty that can be done to decrease the roundness of the nostril.  Usually it entails placing the cartilage as a graft along the rim of the nostril, above the nostril to push it down and sometimes grafts that have both cartilage and skin that are placed inside your nose to push the rim of your nostril. All of these techniques serve to push the rim of the notril down so that they are not rounded and retracted. As you can see below where the label lateral crus is located.  Most techniques entail placing the cartilage grafts above or below the lateral crus to push down the nostril margin or rim to correct the retraction and rounding of the nostril.

Posted in Rhinoplasty / Nose Surgery / Nose job / Nose Reshaping / Nasal Reshaping | Comments Off on Cartilage grafts to reduce the rounding and retracting to your nostrils can be done without making your nose longer looking.

What can make the tip of my nose smaller? What are the options?

Friday, July 2nd, 2010

Temporary Fillers can be an option. Rhinoplasty limited to the tip is a more permanent option for your pointy nose. Your case is a prime example that making a nose smaller is not always the best option to making a nose more attractive.  I discovered a theory which I won an award for that explains why this is.  Your nasal tip should be the approximate size of the colored part of your eye, called the iris.   Fillers could fill around your nasal tip and make it looker larger to decrease the pointy sensation and appearance of your nasal tip.  This is temporary. I would suggest restylane as the best option and this would last from 6 months to a year.  A tip rhinoplasty can improve this as well.  I would sculpt cartilage to increase the size in a subtle way to improve the tips appearance.  This is usually done through an incision at the bottom of your nose that hides really well.  Recovery from a tip rhinoplasty is longer than for a temporary filler. Here is a video of myself doing a tip rhinoplasty.

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, Rhinoplasty / Nose Surgery / Nose job / Nose Reshaping / Nasal Reshaping | Comments Off on What can make the tip of my nose smaller? What are the options?

Is a browlift too early in someone that is in there 20’s?

Thursday, July 1st, 2010

A picture is important to analyze your appearance when you consider a browlift.  Droopy eyebrows can be found in younger people based on their own individual anatomy. Droopy eyebrows can give your a stern appearance.  And appearances can mean everything.  I have a theory on facial beauty that explains this to a degree as well as a blog.  If you eyebrow is one iris width away from your eyelid margin you are near the ideal height.  Being a little higher can make you look more awake. But anything more than 1 1/2 iris widths can give you a surprising look. Sometimes volume under the eyebrow can brighten your eyes by increasing your eyes highlights.  You should send me some pictures.  For older people, volumizing the forehead can be beneficial.  Here is a video of me volumizing the forehead.

Thanks for reading, Dr Young

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

Posted in Browlift / Eyebrow Lift / Brow Lift, Fat Transfer / Fat Injections, YoungVolumizer | Comments Off on Is a browlift too early in someone that is in there 20’s?

Reversing Asian Blepharoplasty and double eyelid crease is difficult but can be done

Thursday, July 1st, 2010

You can reverse Asian Blepharoplasty and double eyelid crease formation (Dr Young Bellevue, near Seattle, Washington).  You are correct that fat injections can be a part of this. But this all depends.  If there is too much skin taken, a skin graft could be needed and the cosmetic outcome could be less favorable in this situation.  Lowering the crease requires elevating the scar and then resetting the crease to a lower height, and then requires fat grafting to the area above the new crease or a tissue graft.  You need experience in this though and there is a learning curve based on my experience. Here is a video on asian blepharoplasty.

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 Reversing Asian Blepharoplasty and double eyelid crease is difficult but can be done

Ptosis in the left eyelid that could be from a previous Asian Blepharoplasty to create a double eyelid crease

Thursday, July 1st, 2010

This was a question a lady asked me after she received a double eyelid crease with her Asian Blepharoplasty procedure.  She felt that her crease was too high and she lost her ethnicity.  She also felt that her left eyelid was lower which made her left eye smaller.  She thought that there might be a ptosis in that eye.

Here is how I answered her question:

Ptosis in the eyelid is correctable and you can lower your crease after Asian Blepharoplasty.   Sometimes doing an Asian Blepharoplasty will reveal a ptosis that wasn’t as apparent before the procedure because the Asian Blepharoplasty can remove the skin that over hangs the eyelid margin that can hide a ptosis.  Ptosis surgery can be done by a doctor that does a lot of Asian double eyelid surgeries.  It just entails shortening the muscle that elevates the eyelid margin called the levator aponeurosis.  This is the same muscle that you have to work with to create the double eyelid crease in Asian Blepharoplasty.  Some choose to wait to do the double eyelid asian blepharoplasty after the ptosis surgery.  In my hands, I have confidence in getting a good result doing them at the same time.  Revision asian blepharoplasty to lower the crease is a difficult procedure.  It entails releasing the scar, and then adding fat into the area to block the readhesion of the crease and recreating the new eyelid crease. Here is a video on asian blepharoplasty.

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 Ptosis in the left eyelid that could be from a previous Asian Blepharoplasty to create a double eyelid crease

My right eye is larger than my left. The lower eyelid is lower on the right which makes it look larger than the left eye.

Thursday, July 1st, 2010

This is something that a person asked me to correct for her.  She has a right eyelid that was larger than the left to a minimal degree. It appeared that the lower eyelid of the right eye was lower in position making the right eye appear larger in general.

This was my answer:

This would be difficult to correct the asymmetry in your eyelids through blepharoplasty.  It seems that your lower eyelid in the right eyelid is lower than the left.  It would be possible to take some skin from the left eye to lower that and this would have to done very carefully.  The risks that this could not be exactly what you are looking for is relatively high. As most of the experts have mentioned, most surgeons would likely stay away from this situation.  You would have to accept the risk that it might not be completely what you are looking for.  Given that your eyes are already pretty, a surgeon would less likely want to do anything.  One thing to remember is that surgery is never as natural as what God created for you.  At least this is not the case at this time.

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 | Comments Off on My right eye is larger than my left. The lower eyelid is lower on the right which makes it look larger than the left eye.

Botox or Dysport both work equally well in decreasing the muscle mass of the jaw muscle called the masseter.

Wednesday, June 30th, 2010

Botox or Dysport both work equally well in decreasing the muscle mass of the jaw muscle called the masseter.  This procedure is very safe. I have never had any serious issues with this use. The amount of botox or dysport to use is dependent on the person because everybody has different responses and different volume of muscle. I usually tell this to people and then explain that I recommend starting at a lower dose like 15-25 units of botox for each side.  Dysport requires 2.5 to 3.0 times the units of botox for equivalent dosing.  Then I tell them that they can see if this adequate muscle relaxation in 2 weeks for botox and 1 week for dysport.  If there is still significant muscle movement of the masseter you can elect to do more.  One important point is that the muscle mass reduction lags behind the muscle movement.  It takes from 3-5 months to see the maximum volume changes in the masseter muscle and then it slowly increases the mass to normal by one year.  So, in short, there are some doctors that are seeing results from botox to the jaws for one year.  In my experience, the mass usually comes back earlier than this but the results are more longer lasting than what can be expected with other facial muscles.

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, Jaw reshaping / Jaw Implants / Jaw Augmentation | Comments Off on Botox or Dysport both work equally well in decreasing the muscle mass of the jaw muscle called the masseter.

Does Restylane lead to collagen production?

Wednesday, June 30th, 2010

Restylane has not shown to produce collagen in studies. But in my experience, I have seen persistent correction of people for longer than what is advertised.  The thought of what process is going on is that there seems to be scar tissue that is forming around the restylane that prevents is degradation.  This is not an uncommon thing that I have noticed in my practice.  I would say that I have seen this in about 5 % of my patient population where they get much longer acting results from restylane injections.  With the manipulation of the needle and the subsequent bruising, I believe that some collagen production is possible but not consistent in my experience.

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 | Comments Off on Does Restylane lead to collagen production?

Chin Implant Revision for misplacement and for aesthetic reasons (when the implant is too large)

Friday, June 18th, 2010

There are many times when I get people that come to my office wondering about changing the appearance of a chin implant that they had before.  I have this case of a woman who had a chin implant by another surgeon and she felt that the chin implant was riding too high. She felt that the chin implant was also too large and it made her look a little masculine.  When it comes to revisions, you should not ever just take an implant out unless it is a really small implant.  What happens is that the soft tissue can ball up and contract and create an unfavorable appearance.  What is typically the better thing to do is to replace the large implant with a smaller one.  If the implant is already smaller, then you could make a case to not put any implant in and this is an option only for a small implant.  Generally small implants are the ones that people have an issue with.  Also when you put an implant in, they implant should alwaws ride on the inferior border of the mandible where the bone is hard and less likely to undergo resorption.  I prefer medpor implants for many reasons.  They can get incorporated and vascularized to act like your own tissue much more so than silicone implants.  Silicone implants tend to have a capsule form around it and will not get incorporated. Hence, when you hit your silicone implant there is more likely the chance for complications years after the procedure as opposed to medpor where once it gets incoporated past 12 weeks, it will be more resistant to infection and rejection. Here is a video showing and demonstrating what we are talking about.

Thanks for reading, Dr Young

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

Posted in Chin Surgery, Facial Implants | Comments Off on Chin Implant Revision for misplacement and for aesthetic reasons (when the implant is too large)

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