Archive for the ‘Wrinkle Treatment’ Category

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Browlifting with Brow Bone Reduction, Hairline Lowering, and Removal of Frown Muscles can Markedly Improve Your Appearance

Thursday, May 20th, 2010

There are many reasons for browlifting (Dr Young specializes in Browlifts and Facial Plastic Surgery) and working with the upper third of the face.  One of the main reasons is to lift the brows when they are drooping.   In this case, raising the eyebrows can open up the eyelids and reduce the upper lid skin laxity.  This can be done through open approaches, through the eyelid and through minimally invasive means through small incisions behind the hairline.  What can also be done is removing the muscles between the eyes that causes the frowning.  This can reduce your needs for botox markedly to not having to need botox at all.  Some people also have significant brow prominence that can be reduced by burring the bone down.  this can be done through an eyelid incision or through an open approach which requires an incision from ear to ear.  Although the incision from ear to ear sounds daunting, the incision actually heals really well when you close it accurately. Also through an open approach you are more likely to get longer lasting results.   Reducing the brow bone can reduce the stern and masculine look that some women have.  Hairline lowering is something that can also be done for people with high hairlines. This is done through an incision right at the hairline.  This combination of procedures, browlift, brow bone reduction, hairline lowering, and brow bone muscle reduction is much more commonly done for certain patients that want to have more of a feminine appearance.  This typically is more common among my transgender patient.  Below is a picture of a just such a patient.  Although we have done this for many women.  Most of the women we have are more conservative in showing their pictures on our website.  Notice in the pictures that his brow bone is less prominent and his eyebrows are elevated to his desired height that we discussed prior to the procedure.  Other procedures that he has were a chin reduction, rhinoplasty, and permalip implants.

Thanks for reading, Dr Young

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

Before

AFTER

Before

After

Posted in Botox, Dysport, Botulinum, Browlift / Eyebrow Lift / Brow Lift, Transgender or Facial Feminization / MasculinizationSurgery, Wrinkle Treatment | Comments Off on Browlifting with Brow Bone Reduction, Hairline Lowering, and Removal of Frown Muscles can Markedly Improve Your Appearance

What is the muscle that causes crows feet?

Sunday, March 7th, 2010

The muscles that cause crows feet are the orbicularis oculi and the smiling muscles: levator labii superioris, zygomaticus major and minor.  Here is a picture of these facial muscles.  When we try to improve crows feet with botox, these are some of the muscles that we try to weaken to decrease the formation of wrinkles.  Botox is injected in the sides of your eyes in the skin to weaken these muscles.  By doing this, we make the muscles weaker so they are less likely to form these dynamic wrinkles.  Dynamic wrinkles are the wrinkles that show up when you move the muscles of your face.  They are more pronounced when you move your facial muscles.  Static wrinkles are the wrinkles that are so etched in that they are present when you are not moving your facial muscles of expression.  Dynamic wrinkles are mostly effected by the actions of botox.  Over time, with continued use of botox, the static wrinkles can become more improved.  This is done because with botox, eventually allows the skin to remodel and reduce the static wrinkles.  This action of improving the static wrinkles however takes a long time and requires regular and consistent use of botox.

I hope that was interesting for you!

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, Dermatology, Fat Transfer / Fat Injections, Fillers / Facial Fillers, Wrinkle Treatment, YoungVolumizer | Comments Off on What is the muscle that causes crows feet?

What are the options for Crows feet?

Saturday, March 6th, 2010

Crows feet are due to the eye muscles that surround the eye. These muscles are meant to close the eye, to blink, to protect the eye, etc.  When doing these movements, they can affect the skin around the sides of the eyes.  What results with this movement are the wrinkles that are commonly called the crowsfeet.  Botox is usually the way that people get some relief for them.  It usually takes about 8 – 12 units of botox on each side and the costs are around 10-16 dollars per unit of botox.  Other options include laser resurfacing, fillers, or fat injections for these wrinkles.

Fat injections and fillers function to do the same thing. When we age we lose volume in the skin and in the whole face in general.  What this does is bring the skin closer to the muscles of our face.  When we were young, there was a greater distance from the muscles of facial expression and the skin.  This distance was occupied by our skins fat and connective tissue.  When you smiled when you were young, the muscles tended to glide under your skin.  The fat in the skin above the muscles of facial expression allowed the skin to slide.  This exact phenomenon occurs in multiple areas of your body.  It is essential for muscle movement in fact.   As we age, the muscles of facial expression become closer to the skin, when we progressively lose the fat and connective tissue within and under the skin.  Hence, progressively when we smile are muscles of facial expression begin to exert more effects on the skin and these are manifested through wrinkling when we smile.  Through fat injections, fillers, or the YoungVolumizer, this layer of fat between the skin and muscles is increased and the muscles of facial expression have less of a wrinkling effect on the skin.

Resurfacing through chemical peels, lasers, or dermasanding / dermabrasion essentially takes away the top layers of the skin to allow skin cells deep within our hair follicles, glands etc to “resurface” the skin.  In the process of the procedure, we remove wrinkles, create a new layer of collagen underneath the skin, remove unwanted pigmenation and DNA damage, remove precancerous or cancerous cells, etc.  The skin then becomes renewed with healthier cells, you have less sun spots, wrinkles and the tone and texture of your skin is rejuvenated.

I hope that was interesting for you!

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, Fat Transfer / Fat Injections, Fillers / Facial Fillers, Skin Care / Intense Pulse Light, Wrinkle Treatment, YoungVolumizer | Comments Off on What are the options for Crows feet?

What is the best treatment for laugh lines? Fillers or Botox?

Monday, February 22nd, 2010

Juvederm is commonly used for laughl lines as well as botox.  It is important to know what you mean by laugh lines.  Many refer to these as the lines around the eyes, or crows feet.  Others mean when the say “laugh lines”, the lines around their mouths or nasolabial folds.  I have a blog that defines those areas if you are interested to know the terms.  But the nasolabial folds are the folds that run from the nose along the sides of the mouth. Whereas the lines below the mouth on the sides are commonly refered to as the marionette lines or puppet lines.  The crows feet can be improved by botox and they can also improve the nasolabial folds to some extent.    Fillers like juvederm can also fill in the nasolabial folds, marionette lines and also help with the crows feet.  In order to really understand how they work a visit to a facial plastic surgeon would be helpful.  Now the difference between fillers and botox is that fillers replace volume that is lossed during aging.  When you lose volume there is an excess amount of skin compared to the underlying tissues.  More skin for a set amount of volume leads to more folding of the skin and hence more wrinkles.  Fillers replace that volume and hence fill in the skin and thereby decrease the ability for the face to make wrinkles.  Botox, which is a neuromuscular agent can make the muscles less likely to contract.  Hence they are most beneficial for dynamic wrinkles, or the wrinkles that are caused by muscular activity.

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 Botox, Dysport, Botulinum, Fillers / Facial Fillers, Juvederm, Perlane, Radiesse, Restylane, Wrinkle Treatment | Comments Off on What is the best treatment for laugh lines? Fillers or Botox?

Glabellar frown lines – The lines between the eyebrows can be improved by these Options by Dr. Philip Young of Bellevue | Seattle

Thursday, February 11th, 2010

Glabellar frown lines – The lines between the eyebrows can be improved by these Options by Dr. Philip Young of Bellevue | Seattle:

Youngvitalizer incision less browlift

Youngvitalizer incision less browlift

What are the options to improve those angry lines in between the eyebrows. Well I will talk about the lease invasive type to the most invasive types.  To begin with skin care is a good place to start.  I would always start with a good skin care line. I would suggest a alpha hydroxy toner, gentle cleanser, alpha and beta hydroxy acid lotion, a retinoid and regular superficial peels.  The goal is to decrease the number of days the skin takes to turnover from the usual 28 days to 10-12 days.  This will help to freshen the skin, lighten brown spots, and decrease fine wrinkles.

The next progression is botox. This neuromuscular agent will keep the muscles from working in between the eyebrows and decrease the dynamic wrinkles.  Over time as your skin remodels, your static wrinkles can improve with continual use of botox on a regular basis. The drawback is the repeated treatments that are neccessary. The positives is the low invasive nature.

The next level is fillers. Restylane, Juvederm, Perlane, Radiesse, can decrease the wrinkles by volumizing the glabella and the area in between the eyebrows.  Volume loss plays a large part in this area.  As this area deflates, more skin in relation to the area leads to more wrinkling.  Also, the decrease in volume places the skin closer to the muscles in this area and allows the muscle to place more influence on the skin and hence more dynamic wrinkling.

Fat injections  is the next level in volumizing this area.  This increases the invasiveness but fat injections can be a more permanent option to filling this area and rejuvenating the glabellar area.
 
Our more permanent solution is called the YoungVitalizer the breakthrough incision less facelift alternative.

A browlift can also help  by elevating the eyebrows and increasing the distance between the eyebrows.  Also during a browlift the muscles that make the wrinkles in this area can also be resected and taken away from the area.  This debulking of the glabellar muscles can also be done from the eyelid incisions.  Another way of decreasing the action from these muscles is to cut the nerve to them through an eyelid incision.

One issue when taking the muscles from the glabellar area is that it can increase the volume loss to this area and lead to more relative extra skin.  This can lead to more static wrinkling to this area and when the muscles come back more dynamic wrinkling that can occur.

In my opinion fat injections to the whole forehead, and in between the eyebrows is the most natural way of rejuvenating this whole region. Also the fat injections with their stem cells can lead to skin rejuvenation.  The other effect of the fat is to increase the distance of the muscles from the skin which can decrease the influence of the muscles on the skin which can allow the skin to remodel on its own and improve static wrinkles.  This occurs because the skin has little cells in the skin layers that always remodel skin on a minute by minute, daily basis.

To change the surface of the skin, a chemical peel, dermabrasion, dermasanding, and laser resurfacing can decrease the wrinkles in the glabellar area.  I always suggest volumizing before resurfacing and reshaping through reductive type of procedures like browlifts, eyelifts, and facelifts.

Thanks for reading, Dr Young

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

Posted in Botox, Dysport, Botulinum, Wrinkle Treatment | Comments Off on Glabellar frown lines – The lines between the eyebrows can be improved by these Options by Dr. Philip Young of Bellevue | Seattle

How painful is dermabrasion? How would you rate the pain level? What are some anesthesia options for dermabrasion?

Monday, January 25th, 2010

Intense Pulse Light is a procedure where a wire brush is used to take down superficial and deeper layers of the skin to reduce scars, improve wrinkles, decrease pigmentary problems, etc.  It works under the same principle as Usually dermabrasion is not done without some type of anesthesia.  The types of anesthesia include local, regional, oral / iv sedation, general anesthesia.  Most physicians use a combination of above to do dermabrasion.  If it is a concentrated area like a scar, local anesthesia can be the only thing needed depending on the normal anxiety levels that a person usually gets in this type of situation.  If the person is likely to get anxious than oral or iv sedation can help.  For the whole face and larger areas, some type of whole body sedation through oral or iv sedation is helpful.  Regional anesthesia where the nerves are anesthetized can help the whole situation.

Thanks for reading, Dr Young

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

Posted in Dermatology, Laser Resurfacing, Scar Removal / scar reduction / scar revision / scar treatment, Wrinkle Treatment | Comments Off on How painful is dermabrasion? How would you rate the pain level? What are some anesthesia options for dermabrasion?

Difference between co2 laser resurfacing with Lumenis and their active fx / deep fx / total fx / max fx technical advances explained

Monday, December 7th, 2009

active_deep_totalfx

skin anatomy

skin anatomy

A knowledge of skin anatomy can help with understanding resurfacing (laser peel, laser skin rejuvenation) of all types including laser, chemical, dermabrasion.  Taking a look at the cross sectional area of the skin, you can see that the skin is broken up into basically two areas, the epidermis and dermis. All resurfacing progressively take away layers of skin and by doing so remove skin lesions, unwanted pigmentation, wrinkles etc.  What happens is that the deeper skin cells located in the depth of the hair follicle eventually resurface and repopulate the skin.  during this process a layer of scar tissue and collagen is formed under the new basement membrane.  This new layer of collagen is thought to be responsible for some of the benefits of resurfacing including tightening of the skin and maintaining the decrease state of wrinkles.  The basement membrane is the connective tissue floor that the stem cells rest on where they reside and repopulate the more superficial layer of skin cells.  Active Fx essentially takes away more superficial layers confined to just above or just below the basement membrane depending on how many passes are done, what power and what density is chosen.  The basic principle of active fx is the use of a fraction of the spot size.  When you look at the picture above you can see that active fx has some wide dots, wider that the deep fx.  But the key are the areas in between the dots that represent untreated skin.  This untreated skin allows a faster recovery and less down time.  The goal is to get some of the effects of resurfacing without the downtime.  To help with the results of active fx, deep fx was added to create more tissue tightening to a deeper level.  Notice in the picture that with deep fx the dots are thinner.  Deep fx is thinner but it reaches to a deeper level heating up deeper layers and leading to more tissue tightening to a thicker amount of skin.  When deep fx is combined with active fx you can get better results than when each are used alone and this is done with less downtime than traditional resurfacing.  Total fx is when active fx is combined with deep fx.  Traditional resurfacing can be explained by active fx and that approach.  The difference is that the dots are much closer together and depending on whether you increase the density of the dots the dots may overlap to a varying degree.  When the dots start to overlap at a density of 4-5 you start to get into more traditional type of resurfacing where all parts of the skin are taken away or ablated per spot.  This approach does not leave healthy skin in between the treated dots, so the downtime is like older approaches. This use of active fx with dots touching or overlapping is more appropriately called max fx, or traditional co2 resurfacing. One thing to remember is that the more aggressive you are the more results but also the more risks are involved.  Total fx tries to get more results than you would normally get with a certain amount of risk. 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 Acne Scar Treatment, Chemical Peels, Dermatology, Laser Resurfacing, Microdermabrasion, Scar Removal / scar reduction / scar revision / scar treatment, Wrinkle Treatment | Comments Off on Difference between co2 laser resurfacing with Lumenis and their active fx / deep fx / total fx / max fx technical advances explained

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?

Non Surgical Face Lift

Sunday, July 19th, 2009

There are many questions out there regarding an alternative for a non surgical facelift.  There are ways to tighten up your face without making incisions.  One way to do this is to undergo a laser resurfacing. We have the lumenis Laser Resurfacing unit and this is proven to be the best one out there on the market. It is the safest and most versatile of all co2 laser units and this can improve your skin by decreasing the wrinkles, improving skin texture, decreasing pore size, tightening the skin and creating collagen under the skin surface to create some more youthful volume.  Co2 laser resurfacing can tighten your neck skin and laxity as well. One thing to remember is that the tightening from a non-surgical face lift with co2 resurfacing will be subtle as compared to a facelift but you can get some results from this.

The other options include using Botox , fillers, and fat injections that don’t require incisions.  Botox / Dysport is a neuromuscular agent that can make certain muscles weaker that helps decrease wrinkles that are from muscular contraction. I have a youtube video to show where you can have botox and how it can help.

When you age you tend to lose volume and this can be replaced with fillers that require injections as an option for a non surgical face lift. Facial Fillers are usually temporary, at least the safer ones and last from 6months to a year or more.  Restylane, Juvederm, Radiesse, Perlane are some options. These modes can be used for the wrinkles between the eyes called the Glabellar region, for the dark circles under the eyes, forLip Augmentation, and many other issues in the face.

Fat injection are another option for a non-surgical facelift and related to this is the YoungLift which I have refined.

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 Botox, Dysport, Botulinum, Facelift / Face Lift / S lift / Mini Lift / Weekend Face Lift / Quick Lift / Image Lift, Fat Transfer / Fat Injections, Fillers / Facial Fillers, Lip Augmentation / Lip Fillers / Lip Injections / Lip Reduction / Lip Grafts / Lip Advancements / Fat Injections of the Lip, Wrinkle Treatment, YoungVolumizer | Comments Off on Non Surgical Face Lift

Does a procedure that works on the corrugators help with bunny lines?

Friday, July 10th, 2009

Your bunny lines are created by the levator labii superioris and transverse portion of the nasalis muscle.  Botox is probrably the best thing for this.  Other surgery to affect the muscles here would likely change your smile too much and might be possibly disfiguring.  The corrugators run from the middle part of the your eye bone and insert into the middle part of your eyebrow.  Manipulating the corrugators improves the wrinkles between your eyes.  Surgery to improve this done and has been done quite a bit.  The corrugators can be manipulated from an eyelid crease incision or through forehead incisions when you do a Brow Lift.

Dr Young is located in Bellevue near Seattle, Washington

Posted in Browlift / Eyebrow Lift / Brow Lift, Wrinkle Treatment | Comments Off on Does a procedure that works on the corrugators help with bunny lines?

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