Archive for the ‘Procedures’ Category

Can a subtle rhinoplasty be done?

Monday, August 31st, 2009

This is a question that someone had regarding getting subtle rhinoplasty results so that her parents wouldn’t find out.  This is how I answered:

Deciding what you want your nose to look like is the most important first step when considering rhinoplasty (nose job / nose reshaping / nose shaping / rhino plasty / nasal shaping).  Figuring out what you want your nose to look like can be done with special computer programs that can morph the pictures of your nose.  Once you come up with an agreement on what that goal is for the appearance then the surgeon and you will determine how to achieve that.  Depending on what you decide the end result could be subtle or could be a bigger and more noticeable change.  But ultimately you should set these aesthetic goals based on your desires of what you want your nose to look like and not what others may want your nose to look like.  After all, it is your nose and you have to live with it on a day to day basis.

To make your nose smaller you may need to bring your nasal bones in as well as make the cartilages in your nasal tip smaller and the cartilage components above the tip more narrow as well.

Thanks for Reading!

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

How to fix bulbous tip on ethnic nose?

Wednesday, August 26th, 2009

This is a question that was asked of me:

Hi, I would like to know how Rhinoplasty is done. If its just the tip, I want to make it pointy. I heard suture technique can give me a pointy tip, without taking out cartillage, I love my nose from the side and the size of my nose, but the tip is bolbous and I don’t like that. Please, what is done to get a pointy tip during the surgery? Thank you.

Suture techniques are a great way to make your nasal tip more refined and pointy and they are potentially reversible during a rhinoplasty procedure (or nose job / ethnic rhinoplasty / asian rhinoplasty / hispanic rhinoplasty / African american rhinoplasty / nose shaping / nose reshaping / nasal tip shaping).  Different techniques can make your nose look different and better in many ways.  One thing that you have to consider in ethnic rhinoplasty is the thickness of the skin envelope over the tip.  If your nasal tip is thick it is harder to make it more refined.  Thinning the skin is an option but that risks the survival of the skin to some degree.  Often times grafting in the nasal tip and creating more structure is what is needed. Your side profile can be maintained while still making the front more refined.

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

Fat grafting: does it last and how long

Wednesday, August 26th, 2009

This is an answer to a question that someone had for me:

How long does Fat grafting to upper eyelids last?How long the result would last?

Fat grafting (fat transfer / fat augmentation / fat injections / liposculpture / liposuction and injection) is the ideal permanent filler substance and can last if done right. Fat is living tissue that requires care from the part of the surgeon to insure survival for the long term.  If the fat survives past 3-6 months, the fat will likely stay in there for many years.  Many people have shown that grafted fat can last for 8-15 years.  The loss of the fat is generally gradual just like your own fat that you had when you were young.  You will always look younger than a twin that never had it done.  To make fat survive you have to be gentle to the fat. I don’t spin the fat, freeze it, wash it, nor add too much ingredients to the mix when I harvest the fat.  Also I place small amounts in many different layers.  The other authors are correct in saying that the there may be the need to do some touchups to the areas for more volume. In the most simplest words, as you age you lose blood vessels for that was supplying the original volume and hence the new volume that you place will require more blood flow that may not exist.  Hence a building up of the volume may be needed.

I refined an amazing volumizing procedure called “null”. 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 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 Y

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

Can the tip of the nose be reduced for the roundness and can it be done without general anesthesia

Wednesday, August 26th, 2009

The tip of the nose can be reduced with local anesthesia without siginificant problems when someone undergoes nose reshaping (nose job / rhinoplasty / cosmetic surgery on the nose / nose shaping / rhino plasty / or rino plasty). You don’t need to be under iv sedation or general anesthesia for reducing the tip.  The tip is easily made numb for tip rhinoplasty.  The tip can be reduced by altering the  cartilages through an incision under the nose.

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

The short scar facelift is limited in the extent of the incision and amount of dissection

Wednesday, August 26th, 2009

There are many different variations of a short scar face lift (mini lift / S lift / Weekend face lift / Lunch time face lift / Lunch Hour Face Lift / short incision face lift). This approach differs from traditional face lifting approaches by the limits in the length of the incision, the depth of incision, the amount of dissection, and extent of improvement.  It really depends on who you go to.  There are ways to limit the length of skin incision and still achieve amazing results through tissue distribution.  Many surgeons out there are making the short scar facelift more a “short cut” face lift where corners are cut and the results are essentially much less satisfactory.  However, there are some very knowledgeable surgeons out there that can use a short scar and do amazing things.  Short scar facelifts usually entail also superficial dissection to avoid exposing facial nerves and is deemed safer by many.

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

There are many options for increasing your nasal bridge height

Wednesday, August 26th, 2009

Rib and Ear cartilage are the most natural ways /sources to increase the height of your nasal bridge during rhinoplasty / nose reshaping (other names for this procedure include nose reshaping / nose shaping / cosmetic surgery on the nose / rhino plasty / rino plasty / nose plastic surgery). Rib cartilage has the advantage of having an abundant supply of cartilage. Their is a tendency to warp and this can be prevented by placing pins inside the rib or by equal carving on all sides of the graft. There are other ways to prevent the warping as well. Ear tends to get absorbed more than rib and also is not as resilient and has a natural bend to it. It really depend on the person whether ear or rib hurts more. In my experience, rib grafting is far more painful than ear harvesting. One option for nasal bridge augmentation is using silicone implants. They are very compatible to our tissues and are almost the ideal implant. You don’t need an extra place to harvest it and can last for as long as you live without absorption, warping, and the need for another area to harvest. The argument against silicone is that is not natural and can lead to infection but there are data out there that shows the rib cartilage can have just as high of a rate for infection during rhinoplasty / nose shaping / nose jobs.

Thanks for reading!

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

Eyelifts / Browlifts / Fillers and how to make the eye look younger again.

Monday, August 10th, 2009

There are many procedures out there that can be done to improve the way the eye looks and to reverse some of the signs of aging (including droopy eyes, extra eyelid skin, tired looking eyes, puffy eyes, eye bags, eye wrinkles).  An eyelift / blepharoplasty (or eye lift / eye plastic surgery) procedure is one way and this entails removing skin from the upper eyelid. Sometimes this entails removing skin, muscle, fat and also recreating the eyelid crease.  Recreating the eyelid crease is perhaps the one thing that can really make an eye look better by reconstituting this crease which can really open up the eye and it appearance.  This is a really complicated part of an eye lift and requires understanding the anatomy to a greater degree and an increase level of expertise.  I have a lot of experience recreating the crease and I have done this with my Asian clientele but I also apply it to my caucasian clientele and other ethnicities.

Browlifts (or brow lift / forehead lift / brow plasty / browplasty / eye brow lift / eyebrow lift) are another way to open up the eye by pulling up the eyebrow to a more youthful position (other signs of aging include droopy eyebrows, hooded eye brows, extra eyelid skin).  This is done through incisions that are placed behind the hairline and hide really well.  Sometimes an incision in the eyelid crease is necessary to better expose the orbital bone above the eyelid and to allow a better approach to lift the eyebrow.  It is important for you to go to a surgeon that understandsFacial Beautyto get those excellent results.  You may have seen people who have a surprised look after a brow lift.  This is direct by product of our limited understanding of facial beuaty. I came up with a new theory on facial aesthetics / beauty which I think really answers some of the questions we have been wondering about facial beauty all of these years.

Fat Transferare all terms used to define a procedure that takes fat from somewhere else in your body and placed into your face or whereever you need more volume.  Fat grafting into the face can have amazing rejuvenative effects to the face by replacing lost volume in the face that have occured through aging.  When we age we lose fat, and our skin thickness gets thinner by losing tissue such as collagen, etc.  Fat grafting just replaces this volume. Fat can be more permanent.  Anything fat or volume that is present for more than 6 months to a year will last for many years, sometimes 8 years or more and up to 15 years. Basically, if you had a twin, you would always look younger than that twin if you had fat grafting and your twin didn’t.

Facial Fillers do the same thing as fat but they are just more temporary lasting 6 months to a year or more depending on the filler that use.  In general hyaluronic acids like restylane, juvederm, and perlane last from 6 months to a year. While Radiesse, a product of bone made up of calcium hydroxyapatite, can last up to year or more.

Both fat and fillers can be placed around the eye to really bring youth to the appearance of the eye.  But a knowledge of facial beauty is much more than half the battle in rejuvenating the eye.

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 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.

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

Otoplasty can really change the way you look for the better if you have prominent ears.

Monday, August 10th, 2009

Q,M 081009 beforeQ, M 081009 after

This is a patient of mine who felt subconscious of her ears and never wanted to wear her hair up because she felt that her ears stuck out too much (or prominent ears / large ears).  We were able to reshape her ears to make them look a lot less prominent through small unnoticeable incisions behind her ear through a procedure called otoplasty, (or ear reshaping / ear shaping / ear plastic surgery / ear pinning / ear cosmetic surgery)  The ear essentially is pinned back with permanent sutures that creates specific curls in the ear and also sutures are used to pin the base of the ear back as well.  This patient wanted to be able to wear her hair up at a wedding and we were able to get a super result to allow her to do that.  She was ready to do normal things in less than a week.

Thanks for reading, Dr Young

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

what type of minor procedure can be done for the small hump on the nasal bridge instead of rhinoplasty

Monday, August 10th, 2009

But these solutions are more temporary and last anywhere from 6 months (Restylane) to a year or more (Radiesse). Fat injections are another solution to augment the nose to hide the bump (or nasal hump / nasal bump / hook nose / prominent nose / large nasal bridge / nasal bridge hump).  When I talk about these injections I mean injecting the fillers above and below the bump to hide it better. This type of procedure can be done in the office under minor local anesthesia with minimal bruising and swelling that lasts only a couple of days versus a week or more for rhinoplasty.

ARhinoplasty (or nose shaping / nose reshaping / nose plastic surgery / nose cosmetic surgery) is essentially any procedure that alters the shape of your nose and that can mean what I just described to the more traditional thought of during a more invasive surgical procedure to change the shape of the nose. A rhinoplasty has been called a nose job or referred to as nose reshaping / shaping, etc.  From a more traditional standpoint, taking down a hump will entail making small incisions within the nose to file down the bump.  Sometimes in order to make the nose appear more normal, you need to cause controlled breaks in the nasal bones to make it close in after the filing takes down the hump.  This type of approach is more longer lasting but does take a little while longer to heal versus the filling techniques that I described above.

Thanks for reading, Dr Young

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

What is the best chemical peel for Melasma?

Monday, August 10th, 2009

Melasma can occur in many different layers of the skin.  Most of the time the melasma is located in the epidermis which is the layer above the bottom layer of skin cells where the stem cells reside.  There are times when the pigmentation gets deposited into the dermal layers, or the layers beneath the stem cells.  Peels differ in the level that they penetrate.  10-20% tricholoroacetic acid null(TCA) usually stay in the epidermis but if applied more times can go beneath the stem cell layer.  20-35% TCA peels tend to go a little deeper and can go below the stem cell layer and get some of the deeper pigmentation.  One thing to remember is that the deeper you go with chemical peels the more time it takes to heal and the more risk.  10-20% TCA peels take 3-5 days to peel and heal. Where as 20-35% will take from 4-7 days or more to heal and peel. A woodslamp can help determine the depth of the pigmentation: contrast in epidermal pigmentation is increased while contrast in dermal pigmentation is decreased under Wood’s lamp illumination compared to ambient visible light. Chemical peels include the vitalase peel, Jessner’s peel, salicylic acid peel, rescorcinal peel, lactic acid peel, glycolic acid peel, phenol peel, retinoic acid peel.

Thanks for reading, Dr Young

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