Archive for the ‘Procedures’ Category
Thursday, July 16th, 2009
If the augmentation is lost, I think it would be okay to consider Rhinoplasty. Facial Fillersis made up of 30% hydroxyapatite and 70% of the carrier. Much of the carrier dissipates over the course of the year. It might be prudent to wait. But if you think the results are essentially back to normal you could consider rhinoplasty and an implant to raise your nasal bridge. What is left in your nose is likely the hydroxyapatite and this could stay in your nose for years. Biopsies of the bladder have shown it to be there for 5 years. Hence if most of the augmentation is gone you could do the rhinoplasty earlier than the full year that it is expected to give you results. If you really wanted to be safe you could wait for the full year to pass.
Thanks!
Dr Young is located in Bellevue near Seattle, Washington
Posted in Fillers / Facial Fillers, Radiesse, Rhinoplasty / Nose Surgery / Nose job / Nose Reshaping / Nasal Reshaping | Comments Off on Radiesse injections to the nasal bridge and how long to wait before rhinoplasty
Thursday, July 16th, 2009
Goretex implants for Asian Plastic Surgeryare usually made out of sheets and are formed by the surgeon to fit the nasal characteristics of the patient. Goretex is made up of fibrillated polymer of polytetrafluoroethylene with pore sizes in the range of 22um which allow limited tissue in growth. It has been determined that pore sizes between 1 and 50 um (micrometers) will allow bacteria to get into the pores but not tissue ingrowth to fight off the bacteria. Hence pore sizes between 1-50 um are not supposed to be good. But there are a lot of surgeons that have used gore tex in the nose without a lot of problems and it has a proven track record in the nose. It is a soft implant and allows the tissue to fixate the implant for a more stable feel. Theoretically the chance of extrusion or rejection of these implants versus silicone should be higher and some studies show that is the case but the chances of this is still pretty low. I have a good colleague that is very well known and totally believes this is the best implant to use in the nose. I however based on experience and knowledge of different products believe that silicone is the best implant for the nose during Rhinoplasty. It is the most compatible of all implants and has a lot of characteristics that come close to the ideal implant. It allows limited tissue ingrowth but is very stable. Some people believe that the implants allow to much movement, are not as stable, and can look unnatural. There are ways to fix the implant to the deeper structures that make the implant feel as if it were bone in certain places such as in the nasal dorsum/ bridge. The silicone implant can also be placed within the tip in a judicious way to augment the tip, raise it and shape it with great success. The alternative to this is to harvest cartilage from the septum or ear with the drawbacks of these areas. Septal cartilage is sometimes sparse in the asian nose and ear cartilage is often times too flimsy and curvy for the nose. Rib cartilage is sometimes the best natural alternative for the bridge and all the other areas an Asian nose might need.
Dr Young is located in Bellevue near Seattle, Washington
Posted in Asian Cosmetic Surgery, Rhinoplasty / Nose Surgery / Nose job / Nose Reshaping / Nasal Reshaping | Comments Off on Best implant in the nose Goretex, silicone for the Asian Patient
Wednesday, July 15th, 2009
Race doesn’t necessarily matter but you want someone that understands the Asian Patient and the nuances that this patient presents. Knowledge of what Asian patients desire and the ability to communicate with them is the challenge. Many Asian patients today desire to maintain their ethnicity with Asian Blepharoplasty. This should mean something to the Surgeon doing the procedure and how to do this surgically is very important. I see many Asian patients that go to Asia to get plastic surgery and they at times come back disappointed. Hence going to an Asian doctor is not necessarily a cure all. You have to go to a doctor that has the repertoire of skills that can treat all conditions that Asians present. Some questions that will need to be answered when discussing Asian blepharoplasty include how high they want the fold, whether the fold should be inside or outside the epicanthus, whether the fold laterally should be parallel or ride higher, whether the epicanthal fold will be dealt with, etc. Here is video on Asian Blepharoplasty and Medial epicanthoplasty.
Dr Young is located in Bellevue near Seattle, Washington
Posted in Asian Cosmetic Surgery, Asian Double Eyelid Surgery / Asian Eyelid Surgery | Comments Off on Will an Asian Surgeon be better suited to treat the Asian Client?
Wednesday, July 15th, 2009
The suture suspension lift most likely refers to a midface lift and there are many ways to do this. You can do it in a minimally invasive way through incisions in the scalp by the temple area. All is needed are very tiny incision near your nasolabial folds to allow the sutures to pull up the middle part of the face. Data on how long this lasts is not sufficient. Most surgeons believe that effect is not as long lasting as other procedures. A midface lift that is done traditionally can be done through incisions in the lower eyelid. This requires the middle part of the face to be released from the bone and then suspended to more superior structures. This can help the nasolabial folds and elevate the midface cheek fat. The results from this, in my opinion, are modest. The reason for this is that the midface issue is really mostly a problem of volume. Fat injections placed in the midface is a good option but not entirely perfect. Implants can give the sufficient volume that is needed to replace what is lost in the midface area. But you have to feel comfortable with implants in your face. The deep plane smas lift is very difficult to do and if you go to someone that doesn’t have a lot of experience with this it could be dangerous. When done correctly, you can get a lot of release and pull on the nasolabial fold area and this can lift the midface in a more lateral and superior direction then just superior. Most surgeons believe that the deep plane facelift will last longer than any suture only facelift 2-5 vs 8-10 year or more respectively for the suture lifts vs the deep plane. These numbers are a pure estimation though but are somewhat supported by scientific review.
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 he uses his internationally acclaimed understanding of facial beauty to create the youthful volume you once had. The YoungLift techniques can help with filling up the lips as well. You can great results with fat injections in the lips.
Dr Young is located in Bellevue near Seattle, Washington
Posted in Facelift / Face Lift / S lift / Mini Lift / Weekend Face Lift / Quick Lift / Image Lift, Midface Lift, YoungVolumizer | Comments Off on Approach to the midface and questions regarding the longevity of midface suture lifts and deep plane smas lifts
Wednesday, July 15th, 2009
The nose has been shown to grow as people age. Much of this growth is actually due to parts of the nose losing its resiliency and structure that it had at a younger age. Cartilages lose their structure and relax and this can make the nose drop from gravity which ultimately lengthens the nose. The ligaments that hold the nose together also loosen over time and this also allows the nose to descend vertically. Also with age, the skin can thicken. Sebeceous gland growth can happen to some degree in everyone but is most pronounced in people with rosacea who can have a rhinophymatous type of changes to the nose. But when the time comes when your nose is larger, there are ways to make it smaller again through Rhinoplasty
Dr Young is located in Bellevue near Seattle, Washington
Posted in Rhinoplasty / Nose Surgery / Nose job / Nose Reshaping / Nasal Reshaping | Comments Off on Will the nose continue to grow even with rhinoplasty at a young age?
Wednesday, July 15th, 2009
Definitely photos are always beneficial to help a surgeon decide what would be the best solution for a particular problem and to reach the desires of the patient. You can reduce the size of the philtrum by excising certain portions of the lip to change the appearance through a directed approach to Lip Augmentation. These excisions can occur inside the mouth and can hide quite well. Sometimes making incisions under your nose can also help change the shape of the lips to get what you want. There are also many different lip advancements that can be done to alter the shape of the lips. Injections can be helpful but would really depend what the desired outcome was. I’m sure if you brought your picture in that a facil plastic surgeon would be able to figure out what was best!
Dr Young 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 Altering the shape of the philtrum / the center portion of the upper lip.
Wednesday, July 15th, 2009
Fat Transferin the neck can work if done right. The key would be to have a result where the fat survives after being transferred into the neck. Once the fat survives past a year, it should stay in the area that it was implanted for many years. Some surgeons have been able to maintain augmentation from fat from 10-15 years. Lumpiness can be a problem but if the surgeon respects how to place the fat this becomes less of an issue. When I graft fat into the face and neck, whenever I’m superficial I always use finer cannulas to transfer the fat. I also lay the fat down as evenly as possible so that each fat transfer aliquot is placed as close as possible to the ones placed next to it. When the fat is injected into the deeper layers, you have more flexibility and less margin for error when you use larger cannulas that deliver larger fat parcels. Fat injections in the neck may not be perfect but one can strive to perfect this. There may not be a better way to volumize the neck. Ultimately, I think surgeons and scientists are going to figure out how to make fat survive better and this will be the main way that surgeons will volumize the face.
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 he uses his internationally acclaimed understanding of facial beauty to create the youthful volume you once had. The YoungLift techniques can help with filling up the lips as well. You can great results with fat injections in the lips.
Dr Young is located in Bellevue near Seattle, Washington
Posted in Fat Transfer / Fat Injections, Necklift / Neck Lift / Platysmaplasty / Turkey Gobblers / Neck Bands, YoungVolumizer | Comments Off on Fat injections in the neck?
Wednesday, July 15th, 2009
The tear trough is a tough area to treat through eye lifts / blepharoplasty procedures. This area is located between the nose and the lower eyelid and is situated not above the bone as most people believe but above the soft tissue of the eye socket and eyelid. People have tried repositioning of the eye socket fat into that area through a blepharoplasty / eyelift procedure. This can work but has been shown to lead to eye position abnormalities and problems with dry eyes, etc. Fat Transfercan work in this area and may be the most natural way to rejuvenate this area. It does have some issues related to survival of the fat. But is the fat survives past a year it will likely stay in the area for many years, sometimes 10-15 years. Fat grafting requires a lot of skill and knowledge of fat survival techniques. Facial Fillers can fill up the volume loss that has lead to the tear trough appearance and I’ve done that many times and have a lot of patients that get this done. The key is being able to fill up the area without leading to bumps and ridges. This requires some skill and with a surgeon’s experience it can be done to look very nice and satisy your clients. Fillers can look not as natural as fat, it can lead to a translucent type of appearance and some dark appearance of the filler within the skin. But, in general >95% or more patients are very, very happy that they had filler placed to treat the tear trough area. Laser Resurfacing can create a layer of collagen underneath the eyelid skin to camouflage the dark appearance of the muscle underneath the skin. It can also tighten the skin and reduce the unwanted wrinkles in the lower eyelid. However, lasers will not replace the volume that is lossed with aging around the lower eyelid area. This is where fillers and fat injections come into play.
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 he uses his internationally acclaimed understanding of facial beauty to create the youthful volume you once had. The YoungLift techniques can help with filling up the lips as well. You can great results with fat injections in the lips.
Dr Young is located in Bellevue near Seattle, Washington
Posted in Blepharoplasty / Eyelift / Eye Lift / Dark Circles / Eye Bags, Cheek Augmentation, Fat Transfer / Fat Injections, Fillers / Facial Fillers, YoungVolumizer | Comments Off on Best treatment for tear trough: lasers, fillers, or fat injections?
Sunday, July 12th, 2009
There are many methods of injecting radiesse so that it is not as painful. Nerve blocks are the best way to make parts of the face numb. You can numb almost the whole face by injecting a few small areas that affect large nerves that control the sensation to large areas. Local anesthesia can then augment the numbness. You can also add lidocaine into the Radiesse. 2% lidocaine is the best to use with the radiesse. Topicals can also help out to insure that the area will not have any pain during the injection. This can help when the regional blocks do not make the complete area numb. Ice is another way to help make the injections less painful. They are also helpful when you do the initial regional blocks to lessen the needle pain when these regional blocks are done. Radiesse injections can be painful without anesthesia so all of these techniques can augment this experience. A dental block may not be the only thing you need. There are other blocks you can do to the face to make almost the whole face numb.
Posted in Fillers / Facial Fillers, Radiesse | Comments Off on What is the best method of injecting radiesse, nerve blocks, ice, etc?
Friday, July 10th, 2009
Anullis the best way to get rid of the extra skin in your face. I’ve done many facelifts on people who have gone through weight loss surgery and they work super on people who have extra skin from losing weight. You should be able to get a super result. Other options include the non ablative lasers and machines that tighten the skin. Deep fx is another way of using a fractionated laser to help tighten the loose skin but these are subtle results. A facelift and neck lift are the best ways to improve this. A facelift pulls up the muscle around your face and thenullgoes through an incision under your chin to tighten the neck muscles. Together they can really shape your neck after weight loss.
Dr Young is located in Bellevue near Seattle, Washington
Posted in 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 What to do about extra skin after losing a lot of weight