Archive for the ‘Procedures’ Category

« Older Entries
Newer Entries »

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?

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:

« Older Entries
Newer Entries »