Archive for the ‘Procedures’ Category

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What do you do for lower eyelid bags, dark circles for someone in their lates 30’s early 40’s?

Monday, August 10th, 2009

Anullcan (or lower eyelid lift / lower eyelid blepharoplasty / lower eyelift / lower eyelid pinch) help by taking away extra skin and removing fat in the lower eyelid (this can also help lower eyelid bags, dark circles, puffy eye bags, dark under eyes). But instead of a lower blepharoplasty, I would consider fillers of some sort to the lower eyelid and cheek area.  What I see in many patients is the volume deficiency at the junction between your lower eyelid and cheek area.  When you age, you start to lose volume in the cheek area by losing fat and losing skin thickness and tissue within the skin.  A lower blepharoplasty could help the transition from your lower lid and cheek area. But a lot of times this procedure can make you look more hollow. I get a lot patients that have this issue after a lower eyelid blepharoplasty.  The better option is to fill the deficiency withFacial Fillers like restylane, juvederm, radiesse, perlane and even better for a long term solution fat injections.  I refined a procedure for volumizing called the YoungLift that does the same but, in my opinion, better that other volumizing 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 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 Blepharoplasty / Eyelift / Eye Lift / Dark Circles / Eye Bags, Fat Transfer / Fat Injections, Fillers / Facial Fillers, YoungVolumizer | Comments Off on What do you do for lower eyelid bags, dark circles for someone in their lates 30’s early 40’s?

Complex revisional plastic surgery procedures

Saturday, August 8th, 2009

When you want to get a revision of plastic surgery in the face and neck you definitely want to go to someone who has a lot of experience with these types of complex revisional plastic surgery.  I specialized in the face and neck and that is all I do.  I trained in Head and Neck Surgery and this has given me an in-depth understanding of the face and neck anatomy. This allows me to understand more complex issues when it comes to revisional facial plastic surgery.  I have a lot of patients that come from other doctors who have less than optimal results due to many different reasons, many of which are not due to the doctors.  Understanding these complex issues allows me to better treat them.  Many people come in for revisions of previous eyelid surgeries, many of which are procedures done in Asia.  Most of the time, these eyelid surgeries or eyelifts / blepharoplasty surgeries have created some unsightly results.  For Asians, creating a double eyelid fold is a popular procedures.  This is a complex procedure which demands a high degree of understanding of the eyelid anatomy.  Some of these revisions are needed to correct multiple eyelid folds, hollowing, asymmetric folds / eyelid height, reoccurence of the single fold, etc.  Depending on the condition, I have to recreate the fold, add skin, graft fat into the area, or take out more skin, take out scar, and reset the crease to a higher level.  Sometimes the muscle that lifts the eyelid is damaged and this can be repaired as well.  This same ideas apply to facelifts, neck lifts, brow lifts, cheek implants, fat grafting, facial implants, other types of eye lifts, rhinoplasty, botox, fillers, scars, laser treatments, etc.

Thanks for reading, Dr Young

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

Posted in Complex revisional plastic surgery, Reconstructive Procedures | Comments Off on Complex revisional plastic surgery procedures

How is a chin implant surgery done

Saturday, August 8th, 2009

Chin Implant Reshaping(or chin augmentation / chin plastic surgery / chin job / chin cosmetic surgery / chin enhancement surgery) are usually done through two approaches.  You can make an incision under your chin or in your mouth to place the implant.  The most common way to do it is through an incision under the chin.  This usually leaves a barely visible scar.  The incision is around 2-3 cm in length and the implant is place on your own chin bone and is fixed so it doesn’t move.  Over time the chin implant will feel like your own bone and like its your natural jaw.  You can also place it through your mouth but this usually has more associated issues with this approach.  First you have to put it past all of the bacteria that usually resides within your mouth and this can lead to increased risk of infection. Also through this approach you usually alter the way the chin muscle sits and this can cause some chin drooping because the muscle is not adequately attached to bone through this approach.  Also with through the mouth, the nerves that brings sensation to your chin and lower lips can be more affected and lead to more chances of numbness.

The usual implant that is placed is silicone which is really compatible to your tissues.  Carbon is right above Silicone (Si) on the atomic chart.  Because they are very similar the body thinks of it like carbon and finds it less intrusive and doesn’t mount a large immune response to it.  Hence silicone implants are highly adaptable to the human body and there is very little risk of cancer, rejection, infection and other problems that you might get with goretex, med por, and other implants. Silicone implants that are solid have been placed in thousands of people with no problems over many years and decades!

Thanks for reading, Dr Young

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

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Posted in Chin Surgery, Facial Implants, Uncategorized | Comments Off on How is a chin implant surgery done

Chin reshaping through implants or reduction can change your appearance dramatically for the better

Saturday, August 8th, 2009

Chin Implant Reshaping/ chin shaping / chin implants / chin augmentation can have a significant impact on the way you look.  There are inter relationships between your chin, your face, and your nose.  Through my theories and studies on facial beauty, the end of your chin and the distance from this point to the center of the lower lip should be about the same distance from your lower lip to your nasal tip.  It should also be the same distance from your nasal tip to the level of the center of your eyes.  All of these distances are ideally equal to the distance from the center of your iris to the middle of your face.  I have found that distance to be ideally 3 iris widths in length.  At the bottom of the chin, the width that it conveys to a person should really be at most 3 iris widths.  But the highlights around the mouth area should be an area that is 3 iris widths radius centered at the lower lip.  This circular area should touch the nasal tip, the lower chin and the nasolabial folds.

On a less techinical side, a chin implant can be placed to make your nose look less prominent.  Prior to having a chin implant, your nose may appear that you would need to make it smaller through a rhinoplasty. But  after a chin implant, you would likely need to do much less reduction and may not even need to reduce the nose in anyway.  This same principle applies to different parts of the nose such as the nasal tip, nasal bridge and whole side profile of the nose.

How would you know whether you need a chin implant.  If you take a picture of a side view of your face, you can determine whether your chin is small or large.  This picture should be taken with the inferior eye bone ridge level with the top of the ear canal.  This is called the frankfort horizontal.  A line drawn through the anterior part of the lower lip, perpendicular to this horizontal plane, the chin should be 1-2 mm behind this line.  If it is more posterior a chin implant could help. If it is more a chin reduction procedure could help. Here is a video on chin reduction for you to see.

Another method is by drawing a line from the half way point from the deepest part of your nasal bridge between your eyes to the nasal tip.  From this halfway point through the anterior upper and lower lips, your chin should be about 3-4mm behind this line. If is posterior to this a chin implant could improve the profile. If it is anterior, a chin reduction could help.

Dr Young is located in Bellevue near Seattle, Washington

Posted in Chin Surgery | Comments Off on Chin reshaping through implants or reduction can change your appearance dramatically for the better

Why is Dr Young an excellent choice for Botox / Dysport.

Thursday, August 6th, 2009

Well to begin with, I’m double board certified in Facial Plastic Surgery and Head and Neck Surgery. When I took the facial plastic boards in 2006, I scored the number one score in the nation on the written exam.  This is the board exam that certifies people who specialize in the face! For botox, one of the most common complications, which happens 3.2 % of the time (to as low as 1.2%), is droopy eyelids.  Of all my injections, I have never had one incident of this.  This is sort of an example of why I’m an excellent choice, as a physician to choose, to have your Botox / Dysport injections.  I have been injecting Botox for around 7 years.  Botox / Dysport can be used for forehead / glabellar wrinkles., crows feet, lip lines, neck lines, neck bands, downturned mouth, gummy smile, lines around the eyes, nasal flare wrinkles.

Dr Young is located in Bellevue near Seattle, Washington

Posted in Botox, Dysport, Botulinum, Uncategorized | Comments Off on Why is Dr Young an excellent choice for Botox / Dysport.

Chemical peel depth and length of healing time for specific lifestyles

Wednesday, August 5th, 2009

This is a question someone had about chemical peels and the different depths and how long it would take to heal:

nullcan help with decreasing unwanted pigmentation, decreasing fine and deeper wrinkles, decrease pore size, improve skin texture, tighten skin, and improve the overall appearance. Basically, the more aggressive you are the more downtime you will have, the better results but the more risk.  When you are less aggressive you heal faster, but you will have less dramatic results. So it really depends on what you want.  Generally a superficial peel will heal and peel in about 2-4 days. A medium depth peel will take anywhere from 4-7 days. And a deeper peel that that such as a medium depth with dermabrasion / dermasanding will take around 6-8 days sometimes.  When you do a peel, you can control the depth of the peel through anatomic signs.  A peel with a little red will be a very superficial peel and heal in 2-3 days.  One with red and a little white specks will be a superficial peel will take 3-5 days to heal or less. One with more complete white and red still present in the background will heal in 4-6 days.  One with solid white will need around 5-7 days to heal more or less.  Pretreatment is often required with a combination of retinA, hydroquinone, and hydrocortisone and should be done for about 2-4 weeks before the peel to be totally safe.

Dr Young is located in Bellevue near Seattle, Washington

Posted in Chemical Peels | Comments Off on Chemical peel depth and length of healing time for specific lifestyles

What are the options for sunken cheeks besides temporary dermal fillers?

Wednesday, August 5th, 2009

This is a questions I answered for someone that was wondering what option there were for sunken cheeks besides temporary Facial Fillers. Fat Transfer or Facial Implants can give you the long term volume you desire in the cheek.

Sunken cheeks is a natural aging process.  When you age you lose fat in your cheeks and this can lead to your tissues descending, wrinkles developing, folds developing, lower eyelid fat protruding, eyelid bags, etc.  Dermal fillers like restylane, juvederm, radiesse, perlane, are temporary and last from 6 months to a year or more.  Of these fillers radiesse is a bone product made up of calcium hydroxyapatite while the others are made up of hyuloronic acid.  There are more permanent fillers like silicone injections, and artefill.  The problem with permanent fillers is that they have the potential to cause infections, scarring and granulomas (balls of chronic infection) that can present years later after you think everything is okay.

Other more permanent options for sunken cheeks include fat injections and silicone implants.  Silicone is very compatible to place in the cheeks.  The silicone atom is one step below carbon on the atomic chart and hence makes it really compatible.  The infection rate with silicone is very low and its use has a long history of safety.  Silicone implants can be placed within the cheek to give a person a more permanent volumizing and lift up sunken cheeks.

Fat injections are another way of volumizing the cheek. Perrmanency depends on whether the fat survives.  This depends on many factors: technique, health of the patient, care of the patient after the procedure, etc.  If fat lasts for more than 6 months to a year, it will likely survive for many years sometimes 10-15 years or longer.

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 is located in Bellevue near Seattle, Washington

Posted in Cheek Augmentation, Facial Implants, Fillers / Facial Fillers, Juvederm, Perlane, Radiesse, Restylane, YoungVolumizer | Comments Off on What are the options for sunken cheeks besides temporary dermal fillers?

Can a forehead augmentation be done after a brow lift?

Wednesday, August 5th, 2009

Forehead augmentation can be done but can affect the results of previous browlifts. You can augment the forehead with silicone after a browlift.  One of the issues is that the augmentation will affect what was done with the previous browlift and you will sometimes need to refix the brows and allow them to fixate in the newer position.  Browlifts depend on the fixation of the bone to the bone covering and the soft tissue that covers the forehead.  When you dissect to implant something into the forehead it will break that bond.  Also with the implant fixating the brows to a new position will present some challenges as well depending on where the implant is placed.  Implants placed in the forehead can establish needed volume that is lossed with aging.  Most of the time, however, forehead augmentation is used to fill in defects from trauma and for reconstructive purposes. Also depending on what implant is used and the size you may need longer incisions such as a variation of the coronal incision that goes from ear to ear.  Not all of this incision is needed most of the time.  In terms of augmentation, you can use silicone sheets / blocks, Facial Fillers or fat augmentation.  Silicone and fat are the options that offer more of a longer lasting results with silicone being more permanent than fat.  Fat injections, however, can be done with no incisions most of the time with less downtime associated with long incisions. Augmenting the forehead can potentially help with wrinkles in the forehead, eyebrow drooping, extra eyelid skin and temple hollowing depending on how and where the augmentation is done.

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.  Dr Young employs the very best techniques from around the world into one volumizing procedure and he uses his internationally acclaimed understanding of facial beauty to create the youthful volume you once had.

Dr Young is located in Bellevue near Seattle, Washington

Posted in Browlift / Eyebrow Lift / Brow Lift, Fat Transfer / Fat Injections, Fillers / Facial Fillers, Juvederm, Perlane, Radiesse, Restylane, YoungVolumizer | Comments Off on Can a forehead augmentation be done after a brow lift?

How to avoid problems with Botox, such as eyelid drooping.

Wednesday, August 5th, 2009

This a questions someone asked me regarding botox:

Botox / Dysport can help with wrinkles in between your eyes or glabella, forehead wrinkles, crows feet, eye wrinkles, bunny lines, chin dimpling, lip lines, lower eyelid wrinkles, gummy smile, neck banding, etc.  In terms of safety, there are a lot of ways to make botox safe and avoid complications. Botox can be done in a safe way to avoid problems.  First off, diluting the botox with less solution can go a long way.  I typically use only 2cc of botox where some other physicians use up to 4 cc of saline.  When you use more saline, you end up needing more volume for the same number of units.  What this means is that the more volume you use the more the botox will be spread out.  When the botox is spread out, it can affect other muscles around the area and cause unwanted effects.  In your specific question, having droopy eyelids can occure when the botox reaches the muscle that lifts up your eyelid.  With a smaller volume with the same amount of botox, the botox is less likely to reach that muscle.  Also to avoid reaching that muscle its important to stay away from the eye or the orbital part of the eye.  As you inject botox as it approaches the middle part of the eyebrow you need to move the injections further away from the eye.  Knowing where to inject makes a big difference as well.  For the forehead, you don’t want to inject the botox too low.  When you inject too low it can lead to your eyebrows descending as well.  I usually try to stay at least superior to the halfway point in terms of the height of the forehead.  Consulting a person specializing in the face is always an important thing to consider.

Dr Young is located in Bellevue near Seattle, Washington

Posted in Botox, Dysport, Botulinum | Comments Off on How to avoid problems with Botox, such as eyelid drooping.

How long does Alar base reduction results take to appear

Wednesday, August 5th, 2009

This was a question that I answered for a person who had a procedure done somewhere else by another physician:

Rhinoplasty during a rhinoplasty / nose shaping / nose reshaping / nose job procedure are done for big nostrils, wide nose near the nostrils, or big noses in general.  The area around the nostrils are called the alae and alar reduction or augmentation is used to change the shape of the alae. Alar reduction results should be earlier than later compared to other results with rhinoplasty / nasal reshaping / nose job  such as tip reshaping / tip rhinoplasty or modifications for a bulbous, big nasal tip. Alar base reduction swelling and the results should be faster when compared to work done on the tip area.  Generally, healing takes place on a logarithmic scale. Simply put, 60% of your healing should take place the first 6 weeks, 80% at 6 months and 89% at 2 years.  You will never have 100% of the strength that your tissues had before the procedure.  So in general, by 6 months 80% of the results should be present.  This is a generality and this is important to understand though. The above percentages are based on wound breakage strength and many surgeons and physicians use this to assess how healing in general takes place.  Usually results with procedures that are done in the tip take a while to be realized while other areas are a little faster like your nasal bridge and work done around the alae.  Your physician should best direct you.  But a second opinion never hurts in my opinion.

Dr Young is located in Bellevue near Seattle, Washington

Posted in Rhinoplasty / Nose Surgery / Nose job / Nose Reshaping / Nasal Reshaping | Comments Off on How long does Alar base reduction results take to appear

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