Archive for the ‘Procedures’ Category

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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.

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?

Solution for the wide nose at the level of the nostrils through Alar wedge excisions, nostril sill excisions, VY advancements, and cinching procedures.

Saturday, March 27th, 2010

Have you wondered if you need to have the skin at the sides of your nostrils reduced or what it takes to make your nose less big at the base of your nose at the level of the nostrils through rhinoplasty (Dr Young near Downtown Bellevue, WA).  If you take a look at the first picture. The green arrow shows where the alae, the tissue that covers the nostril, attaches.  If the alae flares (at the blue arrow) greater than 2 mm than a significant amount of alar flare is present and a alar wedge excision would be an appropriate procedure to narrow the base of the nose which is shown in picture 2.  Do you have a wide nasal base in the first place?  Well if your nose at your base is bigger than the distance between your eyes, you could benefit from some modification of your nasal base. As described for the Alar Wedge Excision above.  The third picture shows the Intercanthal width which is the distance between our eyes by the green arrow.  The Yellow arrow shows the interalar width.  If the Interalar width, the distance between the outsides of the alae, are larger than the intercanthal distance (or the distance between the eyes), than you could benefit aesthetically from some form of treatment to make the nose narrower in the nasal base area ( measured by the interalar width).  When you don’t have alar flaring the excessive interalar width, is due to the lateral attachment of the alae (treated by VY advancement or cinching procedures), excessive size of the nostrils (nostril sill excision), or excessive tissue in between the alae (Cinching procedure, or treating the medial crura that makes up the columnella).   First do you have excessive nostril size?  If your nostrils are horizontally oriented and are wider than the width of the columnella a nostril sill excision would be a good consideration to narrow the interalar width.  In the fourth picture, The green bracket shows the width of the columenella while the yellow bracketing shows the width of the nostrils.  The green arrow shows the nostril sill area where the resection for the nostril sill should be in the horizontal portion as seen in the fifth picture. So in the fourth picture if the green bracket of the columnella is less wide than the nostril sill denoted by the yellow bracket, the nostril sill excision could be used to narrow the nasal base. If alar flaring and excessive nostril size are not present and you still have a wide nose as shown by the interalar width, you can then use VY advancements or cinching procedures to narrow the interalar width.

Thanks for reading, Dr Young

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

Alar FlaringAlar wedge excisionInteralar Width AnalysisNostril Sill 2Nostril Sill Reduction

Posted in Rhinoplasty / Nose Surgery / Nose job / Nose Reshaping / Nasal Reshaping, Uncategorized | Comments Off on Solution for the wide nose at the level of the nostrils through Alar wedge excisions, nostril sill excisions, VY advancements, and cinching procedures.

Asian Rhinoplasty Combination Techniques for both the Nasal Bridge and the Nasal Tip

Saturday, March 27th, 2010

I think that a combination of an implant for the nasal bridge and using your own tissues for your nasal tip is the best combination for Asian Rhinoplasty.  Through years of clinical results through patients and studies conducted by analyzing a different collection of studies have shown many things to us.  The dorsum or nasal bridge seems to be capable of accepting an implant that is made up of silicone porous polyethylene, or goretex. The areas that most likely have issues with alloplasts (foreign implants like silicone, porous polyethylene, and goretex, etc) is around the tip region where the distance from the implant to the environment is the thinnest.  What happens when you put alloplasts in the nasal tip is that the implant can get inflammed and extrude through the skin or inside the nose. This is the reason for using our own tissues in the nasal tip (also called autografts).  I use ear cartilage, or septal cartilage for the nasal tip.  I use my own approach for elevating the tip.  I use the patients own nasal tip cartilages but I use grafts from the septum or ear to prop their nasal tip cartilages into a more desirable position to make the nose look better.  The benefits are that you maintain the natural look of your own tip cartilages while using grafts to make the tip better.  I use the septum and grafts attached to the septum to project the nasal tip to a more pleasing position.

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, Rhinoplasty / Nose Surgery / Nose job / Nose Reshaping / Nasal Reshaping | Comments Off on Asian Rhinoplasty Combination Techniques for both the Nasal Bridge and the Nasal Tip

Permalip Implants can make a big difference in your lips and you can look normal within a week

Saturday, March 27th, 2010

Permalip implants (Philip Young MD Bellevue Washington) are silicone implants that are placed in the lips from the corners of your mouth.  The procedure can take as little as 15 minutes.  It can be done under local anesthesia and the recovery is very fast.  Below are some before and after pictures. The after pictures are taken only 2 weeks after the procedure.  These silicone implants will not dissapear like restylane and juvederm injections.  They are there permanently.

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, WashingtonKL before 01KL after 02KL before 02KL after 04KL before 08KL after 01

Posted in Lip Augmentation / Lip Fillers / Lip Injections / Lip Reduction / Lip Grafts / Lip Advancements / Fat Injections of the Lip | Comments Off on Permalip Implants can make a big difference in your lips and you can look normal within a week

Setting back the Ear during Ear Pinning / Otoplasty is a very important part of the procedure

Saturday, March 27th, 2010

A conchal setback is when the Concha is sewn back to the tissues behind the ear to make the ear more pinned back during an otoplasty or cosmetic ear reshaping procedure (Dr Young is a Facial Plastic Surgeon in Bellevue Washington). Many times a prominent ear is due to the conchal bowl being to developed and strong.  The tissues behind the ear are reduced and then the ear is sewn backward to make the ear appear smaller.  Take a look at the picture below to see what I mean by the concha.  I have found over the years watching many famous surgeons who do ear reconstruction, otoplasty like Dr Reinish and Dennis Crockett in Los Angeles when I was training in LA and Dr Burt Brent in Woodside California that there are a lot of different techniques out there.  I have found that just removing the tissue behind the ear is not sufficient a lot of times to make the ears more pinned back.  I have found that shaving the concha cartilage down incrementally is essential to allowing the ear to more easily and more permanently be pinned back towards the head.    What I learned is that you need to be very incremental in how much you shave.  There should be a little tension in the cartilage when you pin in back otherwise the results can be less predictable.   As show in the picture below, I use a scalpel to take down the cartilage a little at a time and I usually reassess after every short session of debulking the conchal cartilage.  The scalpel is shown pointing to the areas where I have taken down the cartilage.  The first picture is the general anatomy of the ear. The second picture shows the back of the ear displaying mostly the concha cartilage.  The third picture shows the concha after it has been shaved down.  The fourth picture illustrates the cauda helicis or the tail of the helix cartilage that is responsible for protruding the ear lobe.  The forceps or pincer instrument is grabbing the cauda helicis that is reponsible for earlobe protruding.  This cartilage can be excised or taken away or it can be sutured to the concha more to cause the earlobe to be more pinned back as well.  These pictures also illustrate that most otoplasty techiniques are carried out from an incision that is from the back of the ear. This keeps the incision well hidden so that evidence of surgery is hidden and you can avoid looking like you had something done. The last two pictures are some before and afters for you to see what the results are after you get an otoplasty / ear cosmetic shaping procedure.

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

ear anatomyDE 03DE 05DE 06DE 02DE 01

Posted in Otoplasty / Ear Reshaping / Ear Shaping | Comments Off on Setting back the Ear during Ear Pinning / Otoplasty is a very important part of the procedure

Cauliflower ear can be reconstructed through techniques done with an otoplasty.

Friday, March 26th, 2010

Cauliflower ear can be reconstructed through techniques done with an otoplasty (Dr Young specializes in Facial Plastic Surgery and Otoplasty Procedures) procedure.  This is a difficult procedure to do.  It will take sculpting with different instruments using a number of techniques that are often used in otoplasty. The results are usually more on the conservative side.  In my experience, the ear can be made to look a lot better, but getting the ear to look totally like it was before is very hard.

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 Otoplasty / Ear Reshaping / Ear Shaping | Comments Off on Cauliflower ear can be reconstructed through techniques done with an otoplasty.

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