Archive for the ‘Procedures’ Category

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What is a silhouette lift and will it last?

Friday, October 16th, 2009

This is a question I recently answered for someone asking about the silhouette lift which is a variation of a thread lift.

It really depends on how its done, is the bottom line.  If the sutures that they use are not properly placed and done without proper dissection the results will be temporary.  In order for the skin and muscle of the face to take on a new shape a significant amount of dissectiion is required to allow these tissues to readjust for the long term.  I’ve done over 1200 null so I know how the effects of a superficial lift is compared to a more traditional approach. There is a huge difference.  With the minimal dissection they purport, the results are going to be temporary.  Anything done in 45 minutes will not last years based on my pretty extensive experience with 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

Posted in Facelift / Face Lift / S lift / Mini Lift / Weekend Face Lift / Quick Lift / Image Lift | Comments Off on What is a silhouette lift and will it last?

What about Permacol for a nasal implant?

Friday, October 16th, 2009

This was a question I answered from someone who had his ear cartilage implanted into his nose during a rhinoplasty (nose job / nose cosemetic surgery / nose plastic surgeyr / nose reshaping / nose shaping) for a broken nose when he was young that reabsorbed over a year.

That wouldn’t be my top choice. This product will get absorbed and might have a potential for an allergic reaction. The manufacturers state that the implant is eventually replaced with your collagen.  I think that this needs to be further proven.  My position on new products is that I let others make the mistakes with it first and then I’ll use it if it has proven itself over 5-10 years time and has shown a strong safety record.  Because you have had previous implants with yourown ear cartilage I would suggest that you might want to think about rib grafts . Cranial bone grafts are an option but they are considered by many to be too firm in the nose and have a variable absorption rate.  A rib graft does have a significant commitment associated with it that you would need to accept.  An alternative would be a silicone implant that is a better option with your first surgery but less so the more revisions you have. I wouldn’t consider an implant after the first revision.  The risks of infection goes up. But possibly for the second revision if you really didn’t want a rib graft.

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 about Permacol for a nasal implant?

How long after rhinoplasty can I resume normal activity? How about scube diving?

Friday, October 16th, 2009

In general, the first thing to worry about are swelling and bleeding after Rhinoplasty (nose job / nose plastic surgery / nose cosmetic surgery / rino plasty / nose shaping / nose reshaping / nose shaping). Prevention helps and avoiding blood thinners 2 weeks before and after is a prudent thing. Keeping your head elevated is important for the first 24 hours and first week if possible. Your tissues take time to heal. Based on wound strength studies, you gain 60% of your wound strength at 6 weeks, and 80% at 6 months and 88% approximately at 2 years. So you see that it starts to tailor off as you go past 6 weeks and even more at 6 months.  These are the points that I usually tell my patients so they can gauge their activity themselves. Most of the time resuming light activity at 2 weeks and increasing gradually is what I tell people only if everything proceeds as expected. Scuba diving, however, will place some pressure on your nose with the face mask. I would be very cautious about doing this for a while.  To be on the safe side I would wait at least 6 weeks if not 6 months.

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 How long after rhinoplasty can I resume normal activity? How about scube diving?

Can an alar cinch change the shape of the lip and if so what are some other options?

Friday, October 16th, 2009

An alar cinch can effect the way the lips look.  It does this by increasing the volume of the middle of the nose, and upper lip.  To avoid affecting your lips you may consider different type of procedures around the alae to change the way they look.  There are different procedures that involve some minimal incisional techniques that can be done on the sides of the alae to improve their appearance that are lower risk and fast in recovery.  You should definitely go to someone with a lot of experience in doing these types of procedures and you want to have some be very conservative in this.

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 Can an alar cinch change the shape of the lip and if so what are some other options?

Can Birthmarks be removed or reduced with microdermabrasion?

Friday, October 16th, 2009

This is a question that I answered recently.

It could work but microdermabrasion is usually a more superficial procedure. Birth marks usually have a deeper component within the skin.  Microdermabrasion is a superficial type of treatment that is not usually done to remove birthmarks, however. If done aggressively with more suction and more passes you can make the microdermabrasion reach deeper.  There are some microdermabrasion machines that are medical profession strength that can be used more aggressively.  Lasers, actual excision of themark, laser resurfacing, dermabrasion are other options.

Thanks for reading, Dr Young

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

Posted in Microdermabrasion, Uncategorized | Comments Off on Can Birthmarks be removed or reduced with microdermabrasion?

What are the bumps that can form after you have a laser resurfacing procedure?

Friday, October 16th, 2009

This is a question I answered for a patient who had laser resurfacing (laser peels / laser skin resurfacing / active fx / deep fx / total fx / max fx / ultrapulse / co2 laser resurfacing) and bumps a couple of months after the procedure:

They could be milia (clogged pores / acne / plugged ducts / facial bumps / plugged hair follicles). Which are small plugged cysts within a hair follicle. These can be extracted individually. There are also other options including using retin A, topical antibiotics can help and prevent more from forming.  Also microdermabrasion and superficial chemical peels can be done as soon as your skin is healed. At this point for you, being 2 months out you can do microdermabrasion, chemical peels, and before this I would have you start on a cleaning regime exfoliation and retin A. The Retin A will stabilize the skin cells and prevent the pores from cloggin up. From there, the microdermabrasion and the chemical peels (chemical resurfacing / chemical facials / skin resurfacing) will open up the pores and milia and clear the skin.

Here is a live demonstration of my use of a co2 laser and laser resurfacing.

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, Dermatology, Laser Resurfacing, Microdermabrasion | Comments Off on What are the bumps that can form after you have a laser resurfacing procedure?

Fillers, Botox or Lasers for the Under Lower Eyelid Area?

Thursday, October 15th, 2009

This was a question I answered for someone recently:

Restylane is a filler and can be used to fill in the lost volume that is really the cause of the majority of the reason why your lower eyelid looks the way it does. Fat injections, the YoungLift, Juvederm, Perlane, Radiesse are other fillers that can be filled into the lower eyelid area.  The temporary fillers last from 6 months (restylane) to a year or more (radiesse) with perlane and juvederm in between.  Fat injections can last much longer but this isn’t guaranteed but is the best shot for a long term correction.

Botox prevents the muscle around the eyes from squinting which can make the wrinkles less noticeable. Dysport (or botox / bo tox / botulinum / neurotoxin / disport) is a great option.  But these do nothing for the surface quality of the skin and neither does the filler. But the fillers can decrease the amount of wrinkles by filling up the volume.

This is where the co2 laser or other resurfacing procedure (erbium yag, active fx, ultrapulse, deep fx, max fx, total fx, traditional co2 laser resurfacing, laser peel) can help with by decreasing the wrinkles and actually tightening the skin.  A small amount of volumizing also occurs with lasers with their creating of a thin collagen layer deep to the skin.

I hope that helps some!

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, Chemical Peels, Fat Transfer / Fat Injections, Fillers / Facial Fillers, Juvederm, Perlane, Radiesse, Restylane, Wrinkle Treatment, YoungVolumizer | Comments Off on Fillers, Botox or Lasers for the Under Lower Eyelid Area?

Is a chin implant the only way to augment the chin and how does a person occlusion fit into all of this?

Thursday, October 15th, 2009

This was a question I answered for someone recently:

It all depends on your bite.

Edward Angle was the first to classify malocclusion. He based his classifications on the relative position of the maxillary first molar. The mesiobuccal cusp of the upper first molar should rest on the mesiobuccal groove of the mandibular first molar.

* Class I: Here the molar relationship of the occlusion is normal or as described for the maxillary first molar, but the other teeth have problems like spacing, crowding, over or under eruption, etc.
* Class II: (retrognathism, “overbite”) In this situation, the upper molars are placed not in the mesiobuccal groove but anteriorly to it. Usually the mesiobuccal cusp rests in between the first mandibular molars and second premolars. There are two subtypes:
o Class II Division 1: The molar relationships are like that of Class II and the anterior teeth are protruded.
o Class II Division 2: The molar relationships are class II but the central are retroclined and the lateral teeth are seen overlapping the centrals.
* Class III: (prognathism, “underbite” or “negative overjet”) is when the lower front teeth are more prominent than the upper front teeth. In this case the patient has very often a large mandible or a short maxillary bone.

If you have malocclusion, orthognathic surgery (jaw surgery / oral maxillofacial surgery) could improve your chin position especially if you have a class 2 occlusion where the top jaw is more anterior than the bottom. Correcting this can project your chin forward.  If you have a Class one occlusion, and your chin is still posteriorly situated you have what is called retrogenia, or microgenia and a chin implant could improve the appearance of your chin.  Sometimes correcting a malocclusion can still leave you with a small chin and an implant may still be needed. Genioplasty is the actual movement of the bone in a forward and inferior direction to increase the chin size vertically and horizontally.  Chin implants (or chin augmentation, chin enhancement , facial implants, genioplasty, sliding genioplasty, chin surgery, chin plastic surgery, chin cosmetic surgery) can only increase the vertical dimension approximately 2mm anymore usually has traditionally required a genioplasty.  Although there are custom implants that can give you more vertical height of your chin.  Genioplasty is a significant surgery and many people feel it is more work than worth the recovery.  Chin implant recovery is much less than a genioplasty in most hands.  You should come in to discuss this with someone qualified to consult you about this.

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 Is a chin implant the only way to augment the chin and how does a person occlusion fit into all of this?

What is best a neck lift and submentoplasty? Which is best to use for neck laxity.

Thursday, October 15th, 2009

They both can mean the same thing. So you should talk to your doctor and ask him to tell you specifically what he means when he used each of those terms.   A submentoplasty doesn’t have a definite meaning specifically assigned to it.   Since it is part of the neck, I consider it a neck lift or a type of neck lift (or submentoplasty / necklift / platysmaplasty).  Sometimes, surgeons differentiate a submentoplasty as a procedure which is limited to an incision under the chin.  This could be applied to someone that doesn’t have a lot of laxity and someone who has minimal improvement to achieve (or turkey gobbler / neck laxity / neck banding / platysma bands / double chin / turkey waddle / fat neck).  Under this condition, you could limit most of your procedure to the incision just under the chin.  This does make things more difficult for the surgeon however.  Manytimes to make the skin adhere tightly to the new structure created under the chin, you really need to dissect the neck planes and tissue all the back to the hairline and down further.  This is always needed but the more significant the laxity the more you need to dissect posteriorly to allow the skin to redrape.  When you need to dissect more posteriorly, an incision behind the ear becomes more and more necessary.  When you start making incisions behind the ear, it is wise to consider tightening up the neck muscles in this part of the procedure and this is the portion that most people start calling it a neck lift. Personally, I like employing both approaches to ensure that the neck is a contoured as possible.

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 What is best a neck lift and submentoplasty? Which is best to use for neck laxity.

What is the best to replace volume in the upper cheeks filler or fat injections?

Saturday, October 3rd, 2009

Both are good options with positives and negatives. Facial Fillersused for the upper cheeks include radiesse, restylane, juvederm, perlane. These are temporary. Radiesse should only be used in the deeper planes of the cheek especially around the lower eyelids.  The white appearance of radiesse can be seen through the thin skin of the eyelids if you are not careful and place it too superficial. The others are hyaluronic acids and they are clear looking and can be place almost anywhere.  Because they are clear when they are injected into areas of thin skin, your skin can take on a translucent look and sometimes this can look like a very light bruise.  They are fairly easy to put in and you can get relatively quick results but they are temporary lasting anywhere from 6 months to a year or more. Restylane lasts about 6-9mo, juvederm maybe a little longer but it comes supplied with less material 8cc compared to 1.1cc of restylane. Radiesse lasts about a year sometimes more or less.

Fat injections however can last for many years.  Usually you can get approximately 60-90% of the fat to survive depending on how well you do the procedure. Because it is a living tissue technique is vital to insure survival of the fat.  When carefully placed fat is the most naturally looking of all filling or volumizing type of procedures.

I refined an amazing volumizing procedure called “the YoungLift”. This is an innovative technique that volumizes your face to bring out the younger and natural you without looking like you had something done. This is not a facelift and requires no incisions. Only pinpoint puncture sites are used and these heal imperceptibly. The YoungLift can be done without general anesthesia and without drains, and large bandages. You also have sometimes a lot less downtime and discomfort compared with traditional facelift procedures. I employ the very best techniques from around the world into one volumizing procedure and I use my internationally acclaimed understanding of facial beauty to create the youthful volume you once had.

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, YoungVolumizer | Comments Off on What is the best to replace volume in the upper cheeks filler or fat injections?

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