Archive for the ‘Procedures’ Category

« Older Entries
Newer Entries »

What to do for an upturned pixie ear. And are all rhinoplasty surgeons created equally?

Monday, December 7th, 2009

What is important is how pleased you are with your nose. A turned up nose can be turned down so to speak through Rhinoplasty(rinoplasty, nose job, nose augmentation, nose plastic surgery, nose cosmetic surgery).  When you go see a facial plastic surgeon, you should ask to see what your nose would look like by altering it on a computer with a special imaging program. The surgeon can get a better idea of how to achieve what you want.  Also rhinoplasty surgeons are not created equally.  There are surgeons who specialize in rhinoplasty more than others.  One thing to realize is that its not how many the surgeon has done, its how many good rhinoplasties they’ve done.  The upturned nose may require lengthening or relative shortening to achieve the look you want.

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 to do for an upturned pixie ear. And are all rhinoplasty surgeons created equally?

Chin reduction and other techniques can reduce a cleft chin, and chin dimpling

Monday, December 7th, 2009

Chin dimpling is thought to be caused by a lack of soft tissue in the middle of the chin.  The soft tissue can be muscle (mentalis), fat, etc.  What also contributes is the bony structure.  When the bone forms two mounds on each side of the midline, a cleft can appear. Chin reduction surgery (chin cosmetic surgery, chin plastic surgery, chin shaping, chin reshaping, chin enhancement surgery) ,is one element of removing the cleft by decreasing the mounds of bone that can be contributing to the cleft.  If the soft tissue causes the cleft to persist, the surgeon may need to fill the cleft in with soft tissue brought in from somewhere else.  This tissue can come from fat, muscle, etc or even manufactured tissue. Here is a video on chin reduction for you to see.

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 | 1 Comment »

Can the area under the chin in the neck be made to look good even without the help of a chin implant?

Monday, December 7th, 2009

A chin implant and augmentation can improve the lax tissue under the chin by pulling up the tissues that are causing the sagging double chin.  It can improve the neck lift even more than when a neck lift is done alone.  A neck lift (Platysmaplasty, Neck Rejuvenation, Lower Face lift, Necklift, submentoplasty, double chin surgery, turkey gobbler surgery, neck enhancement) done well though can significantly tighten the neck.  The key is how the platysma muscle is treated.  This muscle is essential to how the neck looks.  When doing a neck lift, the platysma must be tightened from just under the chin to the bottom of the neck area.  This changes the structures of the neck for a better shape.  There are also other adjunctive techniques that can be done to the fat, tissues and the muscle under the chin which can also improve the way the neck looks.  Another very important key to tightening the neck is by making sure that the skin of the neck has a place to go.  Elevating the skin to a certain degree is essential to allow the skin to shift to a more shapely appearance.  All of this takes experience and knowledge on the part of the surgeon.

Thanks for reading, Dr Young

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, Necklift / Neck Lift / Platysmaplasty / Turkey Gobblers / Neck Bands | Comments Off on Can the area under the chin in the neck be made to look good even without the help of a chin implant?

What are the options for removing the dimple on a chin?

Monday, December 7th, 2009

Chin dimple removal can be done. The origin of this anatomical variant is due to lack of the mentalis muscle crossing over and leaving a dip.  Some others believe that the dimple is due to other soft tissue deficits.  Whatever the orgin, one may need to elevate the area and fill it in with fat or some other filler.  Because the skin is usually tacked and attached down to the deeper structures, some surgical lifting is necessary.  After lifting, you will then need to place some tissue there to keep it elevated and not associated with the skin again.  This is where grafts can work and there are many options for that.  Fillers are less efficacious in my experience. Chin implants can also serve to make those dimples less apparent as well but may change the way your chin looks in a significant way.

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 What are the options for removing the dimple on a chin?

What results can I expect from scar revision surgery after worsening scars around my ear and face?

Monday, December 7th, 2009

It always depends on what your scars look like.  Options for Scar Revision (scar treatment / scar improvement / scar reduction, scar removal) include:

1. excision and reexcision: straight closure, running w plasty, multiple z plasties, geometric closure.

2. skin resurfacing: including laser, dermabrasion, chemical peels

3. tissue expanders to recruit more skin

4. local flap surgery whereby skin and tissue are recruited to reline the areas of scars

5. free flap surgery where tissue from some other part of the body is transferred to the areas of the scars and connected with blood vessels.

Many scars are excised and reclosed.  There are many options with this approach.  You can cut the scars out and close them as a straight line.  Your eye however usually notices anything that is longer than 7mm.  So many times, it helps to close the new incision not in a straight line but broken up into “w’s”, “z’s”, or multiple patterns (geometric line closures).  This is done in attempts to trick the mind by not having any line longer than 7mm.

Resurfacing is always an option to improve the scar by taking the scars away on the surface and allowing new skin to grow over to improve the appearance.  This can be done with lasers, dermabrasion, chemical peels, and dermasanding.

If there is a big area to improve, sometimes having more normal looking tissue is needed. This is where the concern with bringing in tissue comes into play. Tissue expanders allow you to make more skin. You have to go through expansion of your skin with a balloon under the skin near the area you are wanting to correct.  Expansion occurs every 2-3 weeks.  Once you have enough tissue you can then take the expander out and then the new tissue is used to reline the scarred area.  Local flaps can be rotated into the area.  If this is not enough, you can then take skin and tissue from another area and hook up the vessels to reline the scarred area.

The other option includes fillers that are an adjunctive option.  Fillers essentially fill in the volume deficiency that sometimes is present in the scarred area.  Fat injections, which are a filler that uses your own fat can fill in volume and also regenerate your skin through incorporation of new stem cells in the fat.  These stem cells can have a regenerative property on scar improvement.

From a results standpoint, you shouldn’t expect it to make your scar back to complete normal.  This is impossible.  But through scar revision the scars can be really improved.  That is the key to scar revision the word “improve”.  Here is a video on Scar Revision.

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, Scar Removal / scar reduction / scar revision / scar treatment, Uncategorized | Comments Off on What results can I expect from scar revision surgery after worsening scars around my ear and face?

lumps and bumps 3-4 days after lip augmentation with Restylane

Monday, December 7th, 2009

The swelling in the lips usually takes a while to go down after Lip Augmentation (lip filler, lip enhancement, lip plumper, younger lips, lip injectibles) with Facial Fillers. Your lips are very vascular and with that comes easier bruising and swelling. 3-4 days is on the early side. I usually wait for the first 2 weeks for the swelling to go down.  During these first 2 weeks is when massage can really help dissipate the swelling.  Enzyme injections are also another way of removing restylane, juvederm, perlane but they are more of a permanent removal of the restylane.  If enzymes are injected during the first 2 weeks, this may be a mistake.  The swelling that would normally go down the first 2 weeks will further go down more if enzymes are injected the first 2 weeks.  Sometimes waiting at least 3 weeks is even better.  One thing to remember is that restylane and other hyaluronic acid fillers can be shaped though and you shouldn’t have to go through 6-9 months of a less than desirable result.  Enzyme’s can help shape your results after 2-3 weeks.  Notice how in the example that the lower lip in the after maintains the size that is 2 times greater than the upper lip.  From the viewer standpoint, it doesn’t look wierd to them.

Thanks for reading!

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

Before Restylane Injections / Lip augmentation

Before Restylane Injections / Lip augmentation

After Restylane Injections / Lip augmentation

After Restylane Injections / Lip augmentation

Posted in Fillers / Facial Fillers, Juvederm, Lip Augmentation / Lip Fillers / Lip Injections / Lip Reduction / Lip Grafts / Lip Advancements / Fat Injections of the Lip, Perlane, Restylane | 5 Comments »

What are some permanent options for Lip Augmentation?

Saturday, December 5th, 2009

Some permanent options forLip Augmentation (Or lip enhancement, lip filler, lip injectible, lip plumping, lip rejuvenation) exist including Lip Lifts, Mucosal advancements, Lip Grafts, Fat injections, and Permanent Lip Fillers.  Lip lifts include Buffalo Horn Lip Lift (gull wing lip lift, wavy under nose lip lift) which are under the nose that lift the upper lip and shorten the distance from the bottom of the nose to the upper lip. Corner of the lip lifts elevate the corners of the lips to reverse downturn lips. Mucosal advancments including V-Y advancements that can be horizontal, vertical, and double ones that do different things.  These advancements increase the red portion of the lips appearance in both the upper and lower lips. Lip grafts can be done with alloderm, goretex or other natural tissues from various parts of the body.  They can be used to increase the volume of the lips for a fuller more youthful look. Fat injections can be employed to volumize the lips, and increase the red portion of the lips with your own fat.  This is an option that can last for years.  Permanent lip fillers, like silicone, are another option but present a lot of risks. My opinion is that these permanent lip fillers are too risky.

Thanks for reading, Dr Young

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

Posted in Lip Augmentation / Lip Fillers / Lip Injections / Lip Reduction / Lip Grafts / Lip Advancements / Fat Injections of the Lip | Comments Off on What are some permanent options for Lip Augmentation?

Is overfilling possible with new fillers like restylane that were more likely with Collagen fillers

Friday, December 4th, 2009

Hyaluronic acid fillers (dermal fillers, dermal injectibles, restylane, juverderm, perlane) present a great option forLip Augmentation (lip enhancement, lip filler, lip injectible, lip plumper, lip rejuvenation, lip wrinkle filler/treatment). Hyaluronic acid fillers like restylane, juvederm, perlane, etc are a great way to augment the lips.  They allow accurate filling and you always have the options of using enzymes to dissolve the fillers for accurate touch ups.  I have an approach that allows me to manipulate the fillers based on how long the fillers were injected.  So poor results should be a thing of the past.  Also a knowledge of facial aesthetics is indispensable. I discovered a new theory of facial beauty, called the Circles of Prominence, which can be read on my website. Essentially, the lower lip should be at least 2 times the size of the upper lips. The puckering of the lower lips should emulate the eyes. Here is the link for my theory on facial beauty: http://www.drphilipyoung.com/pdf/circles_of_prominence.pdf.

Thanks for reading, Dr Young

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

Posted in Fillers / Facial Fillers, Lip Augmentation / Lip Fillers / Lip Injections / Lip Reduction / Lip Grafts / Lip Advancements / Fat Injections of the Lip | Comments Off on Is overfilling possible with new fillers like restylane that were more likely with Collagen fillers

Will fat grafting make me look fat and can you do fat grafting in the lower eyelid with a lower eyelid blepharoplasty?

Tuesday, November 17th, 2009

Fat injections (fat filler, fat transfer, fat grafting, pearl fat grafting) done right will not make you look fat just younger. Repeating the lower eyelid blepharoplasty and doing fat grafting is not a familiar course for me. I either do one or the other and I tend to do more fat grafting.  I only consider the lower blepharoplasty with fat grafting when there is an extraordinary amount of fat in the lower eyelids and this is not common.  Most of the time when you remove fat and skin from the lower eyelids you tend to look hollow there.  Fat grafting as a whole can really help this area by bringing back the volume to the lower eyelid and upper cheek area.  Also combining the two procedures can have an impact on the fat survival in my experience.  With fat grafting, I always have patients bring in photos of themselves when they were between 10-20 years old.  This helps me to determine where to put the fat.  Fat grafting will not necessarily make you look fat at all. When placed correctly, it can dramatically make you look younger.You just need to put the fat in the right places. Also browlifting is more complicated than most surgeons think.  A little can do a lot to make someone look surprised.  Many times fat grafting around the eyes, temple, and forehead can really make someone look younger in this area while elevating the eyebrows or giving the illusion that it has been elevated. You can see my before and afters at this link: http://www.drphilipyoung.com/procedures/youngvitalizer/

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, Browlift / Eyebrow Lift / Brow Lift, Fat Transfer / Fat Injections, Uncategorized, YoungVolumizer | Comments Off on Will fat grafting make me look fat and can you do fat grafting in the lower eyelid with a lower eyelid blepharoplasty?

What percentage of body fat do you need to be a candidate for fat grafting?

Tuesday, November 17th, 2009

Studies looking into the percentage of body fat are not prevalent in the literature. So this hasn’t been determined accurately. Because you work out regularly and have low body fat, you might not be the best candidate for a lot of Fat Transfer(fat injections, fat transfer, fat filler, fat injectible). I would reserve fat grafting for areas that are least likely to tolerate more permanent fillers or implants.  These areas would be around the eyes and in the cheek hollow area.  The alternative for the areas other than that are sculptra, silicone implants for a more semi permanent or permanent options.  Temporary fillers can be used everywhere essentially.  Temple hollows, forehead volume loss, jaw shrinkage and sunken cheeks can be augmented with silicone implants as an option in the very thin or fit patient.  Fat can then be used in the areas that cannot tolerate these implants.

Thanks for reading, Dr Young

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

Posted in Facial Implants, Fat Transfer / Fat Injections, Fillers / Facial Fillers | Comments Off on What percentage of body fat do you need to be a candidate for fat grafting?

« Older Entries
Newer Entries »