Sculptra injections and how they are administered

January 15th, 2010

Sculptra injections are conducted like other fillers.  Usually topical medications are used to numb the skin.  Then sculptra is usually reconstituted with lidocaine local anesthetic.  Together this allows the injecions to be done in a tolerable way.  Sometimes nerve blocks are done to make the injections easier.  There are multiple nerve blocks that you can do to make the Sculptra injections more tolerable.  But these “dental blocks” are not for everyone.  Sometimes, people prefer topical anesthetics and the anesthetics in the Sculptra itself without nerve blocks.  But if additional numbing is required nerve blocks can make the procedure more tolerable. A few injections are usually needed for each area.  The first injections are always the more difficult ones.  Once the first injections begin to allow the local anesthetics to take effect, subsequent injections are much easier to tolerate.  They are usually given every 6-8 weeks.  The sessions take about 1/2 hour.  You are a litle swollen but this goes down shortly in a matter of hours.  The Sculptra then begins to incite an inflammatory response that eventually creates the volume that is needed in the form of collagen.  This process of building collagen can take months to about a year.  This process of collage formation creates the volume that helps make people look younger.  The key to getting a good result is really technique dependent. You have to know where to put the volume to rejuvenate the face.  If you don’t, you can accentuate more of the curves that lead to aging rather than the reverse. Unlike other fillers, Sculptra takes time to work with less instant gratification but more long term results. Here is a live demonstration on Sculptra injections.

Thanks for reading, Dr Young

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

More on Brow lifts and the YoungVitalizer by Dr. Philip Young of Bellevue | Seattle:

January 14th, 2010

More on Brow lifts and the YoungVitalizer by Dr. Young of Bellevue | Seattle: This is a followup on browlifts done in a natural way.  As I have said before, aging is really a process of losing volume.  The loss of volume in the forehead, temple and around the eyes leads to the eyebrow drooping.  When someone comes in to see me, one question that I always ask is whether they want to look like how they were when they were younger, in terms of where the eyebrow sits, or if they want to look differently.  If a person wants their eyebrow to be more elevated then they ever were, than a browlift through surgery and incisions is probably the best thing for them.  If they want to look more like they were when they were younger then volumizing might be better suited for the person. Here is a picture of a browlift using our incision less technique:

Youngvitalizer incision less browlift

Youngvitalizer incision less browlift

If they want to look how they did when they were younger, volumizing around the eyes, under the eyebrow, above the eyebrow and in the forehead and temple can do amazing things.  The loss of volume in this area allows the brows to fall lower and also the loss of volume under the eyebrow and within the area aroung the eye allows the skin to deflate and this leads to extra skin around the eye.  Usually, historically, plastic surgeons tended to reduce the tissue in the face through facelifts, eyelifts, browlifts, etc.  When you age you change from a grape to a raisin.  Hence surgeons typically made the raisin into a smaller raisin. With this approach, you can look better but you don’t look like the grape and younger in a natural way.

One thing I realized in my approach to volumizing is that one of the most difficult areas to improve is the upper eyelid area and eyebrow area.  The face is essentially part of the whole head.  I know this is like a “duh” answer. But what I mean by this is much more complicated in a three dimensional view and from a beauty perspective.  So really it isn’t a “duh” subject, if you know what I mean.  The face has to be presented to the viewer, most importantly, from the frontal view.  Hence to make a face beautiful from the front, you need to present all the features so that the face is prominently presented to the viewer.  This objective has to be accomplished given that the face is attached to the head that eventually has to proceed backward towards the back of the head.  Why is that important? Well the face has to be volumized in order to push all the elements of the face forward so that when it is seen from the front it appears the best from this vantage point.  Hence volumizing needs to pay attention to this detail.  When one volumizes the face, the lateral parts of the face needs to have more volume to push those elements forward so that from the front they occupy a prominence to present the face beautifully to someone seeing them from the frontal view.

A big question is then presented to surgeons like me.  If we volumize symmetrically in all the areas of the face, won’t you recreate what the person had when they were younger. This could be true so that you wouldn’t have to volumize more of the lateral areas of the face.  But this all depends on the particular person and how they were built.  You see, sometimes beauty is created by soft tissue or hard tissue. If it so happens that a particular person’s beauty is created by hard tissue like bone, they are more likely to hold on to their beauty.  My wife’s family is like that.  Their cheeks are made of bone and not soft tissue.  So you have to determine how much of there bone structure is still present.

How does this apply to browlifting and rejuvenating the eye region? Well you have to determine how their eyebrow is currently shaped and how they were when they were younger and what volume will get them to the past.  I usually find that most people require much more augmentation in the lateral part of the brow. But typically I augment the lateral brow 2-3 times more than the medial part of the brow.  When I volumize I usually also have the tendency to augment so as to lift the eyebrows with more of the augmentation under the brow and above the eyebrow.  See below for an example of augmenting the whole face and especially in relation to this post the eyebrow and the upper eyelid region.  “The YoungVitalizer” procedure was done for this patient below.

Thanks for reading, Dr Young

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

A browlift can be performed with just filling certain areas of the face through the YoungVitalizer

January 13th, 2010

I refined an amazing volumizing procedure called “the YoungVitalizer”. 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 YoungVitalizer 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.

In terms of a browlift (or brow lift / eyebrow lift / eye brow lift / foreheadplasty / browplasty) you can fill in certain areas of the face to lift the brows. One thing to remember is that with volumizing tissues tend to follow areas that are volumized.  For example, volumizing the cheek next to the inferior and laterally next to the eye, tissues will tend to follow towards that portion of the cheek.   When that cheek receives more volume, the nasolabial folds and jowls began to migrate toward that lateral cheek area.  This same principle applies the eyebrow.  To elevate the lateral portion of the brow, the area above and lateral to the brow will need to be filled.  Take a look at some pictures of beautiful people and you will notice that there is an area above and lateral to the eye and brow that receives a lot of highlights from whatever light source that particular face is located under.  Hence to lift the brow you need to place tissue above and lateral to the eyebrow in the forehead and temple region.  One thing to realize is that augmenting close to bone serves as a foundation to have tissue migrate towards the volumized area.  This foundation needs to dominate the filling.  If you want the eyebrow to lift you need to place the tissue above and lateral.  If you place too much tissue in the eyebrow itself, this filling can dominate and prevent the eyebrow from migrating to where you want.  Also when you augment next to bone below the eyebrow in excess the eyebrow will tend to migrate inferiorly.  All this takes skill to master and the more experience in volumizing the better.

Thanks for reading, Dr Young

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

The YoungLift is being changed to the YoungVolumizer

January 11th, 2010

This blog discusses our name change from the YoungLift to “The YoungVolumizer”.  We had to change the name for various reasons.  My wife actually came up with the name YoungVolumizer.  I was thinking about the name for a while and when she told me her idea of the YoungVolumizer I instantly liked it.  I then discussed it with the rest of my staff and they felt that it was also a great name.  We are making people look younger by volumizing their face. We hope our readers and followers like this new name.

Thanks for reading, Dr Young

Dr Young is located in Bellevue near Seattle, Washington

The face is an oval with a number of shapes within that oval. The beauty of the face is determined by how those shapes are arranged.

January 9th, 2010

What are those shapes? Well within that oval the anatomical major units are the eyes, nose and mouth.  These major units must be symmetrically arranged and the units must be arranged in an orderly manner.  How is this possible? Well what I thought was important was to find out what shapes are the most important within each of those major units.  Within the eye, the iris is what I concluded was the most important.  Within the nose, the nasal tip is the most important.  Within the lip, the lower lip is the most important and specifically the center of the lower lip.  These shapes; the iris, nasal tip, and center of the lower lip must be balanced among each other.  When there is balance between the iris, nasal tip and lower lip a very important element of beauty is reached.  What I found and was able to scientifically prove to a degree is that when the distance from the iris to the midline, distance from the horizontal level of the iris to nasal tip, the distance from the nasal tip to the lower lip, and the distance from the lower lip to the bottom of the chin is equal to each other a very basic level of beauty is found to be present within that particular face. When this not present the imbalance of these relations starts to create tension between the anatomical units of the face.  When the iris is closer to the nasal tip the major unit of the eye and nose starts to get crowded and this tension creates a sense of uneasiness to the viewer and hence less beauty is assessed from the viewer.  When they are more in balance more beauty is achieved. You can read more about this by reading my paper.

Thanks for reading, Dr Young

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

How I started to discover the answer to facial beauty

January 9th, 2010

This is a follow up to my discussion about how I began to do what I do and what my fascination is regarding facial plastic surgery.  During residency, we were required to write a scientific paper.  These beginnings into research gradually directed me into my current strong interest in the field of facial aesthetics or the theories regarding facial beauty.  I knew that I wanted to make a strong contribution to my field but I didn’t want to write on a frivolous subject.  So I looked into issues that could make a big impact.  In one of my blogs, I talked about how I found that our current understand of facial beauty were still based on theories that were from the 1400’s with little improvement in our understanding.  These rules that we were still basing our decision making on were called the neo classical canons from Leonardo Da Vinci.  It has been only recently in the past few years that we have begun to find in our scientific discovery that these rules don’t differentiate the beautiful from the average.  Dr Farkas wrote a lot of papers on this subject.  Some people have found that averageness is beautiful.  Another author found in his study of inmates, to look for facial characteristics that would suggest a greater tendency to commit crimes, took the average proportions of the inmates to look for these traits. What he found was that the average proportions actually created a face that was more beautiful than the rest of the inmates.  This is were averageness is beautiful as an idea became popular.  Further studies by Perett and colleagues, published in Nature, have shown that something more than average creates beautiful.   But we still didn’t know the answers.

One night, when I was in Syracuse for an interview. I couldn’t sleep.  My mind was busily thinking about the answer to facial beauty.  It was then that I had an “aha” moment, when I discovered the Circles of Prominence.  I knew that a theory had to be based on something that we concentrated on a lot when we look at the face.  Naturally I looked to the eyes.  But what was it that was important.  I concluded that it was the iris, the colored portion of the eyes.  That is probably the reason why our whites are so stark white to bring out contrast of the iris color.  The other idea that I found very useful during my studies in mathematics is the values zero and infinity.  Most all numbers are between these to extremes.  In the face there has to be an ideal from zero and infinity.  If we spend so much time looking at the iris, my feeling was that the iris was that ideal between zero and infinity.  Hence the width of the nasal bridge, nasal tip size, distance from the nose to the upper lip, the height of the lower lip are all one iris width.From there I started thinking about the other rules of facial beauty.  You can read more about this by reading my paper.

Thanks for reading, Dr Young

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

My background and how I came to do what I do

January 9th, 2010

One moment of my life that made a huge impact was the loss of my mother.  This occured when I was an undergraduate at the University of Washington.  This was obviously the saddest moment of my life.  I think that experience made me really appreciate life.  When I started undergraduate school, I began as premed.  I always wanted to be a doctor. My father was a real estate developer and that began to influence me.  During my first year, I switched majors to start to concentrate in Business.  I was accepted into the School of Business and started going to classes.  After the passing of my mother, I had a rejuvenated desire to return to medicine and did a total switch into that route.  That eventually led me to Tulane medical school in New Orleans, Louisiana.  I choose this school because it was located in a city that was totally different from Seattle, Washington.  It was a complete culture shock there but an amazing experience.  While in medical school, I was fascinated by the anatomy of the Head and Neck region.  This influenced my concentration of my studies toward Otolaryngology, which is the specialty of Head and Neck Surgery, commonly known as ENT, or Ear Nose and Throat.  I was then accepted into the residency program at University of Southern California, which is one of the top schools in the country. During residency, I had a broad range of experience in this field. I originally thought that I would go into the treatment of Head and Neck Cancer.  While learning this particular subspecialty, I was introduced to the reconstructive aspects of this specialized field.  Coupled with the very difficult role of diagnosing and being the bearer of bad news for people with cancer, this interest in the reconstructive aspect motivated me to learn more about the subspecialty of Facial Plastic and Reconstructive Surgery.  As I learned more about the field of Facial Plastics one element of this field began to fascinate me more and more.  One thing I noticed while in Los Angeles were the less than optimal results from plastic surgery that was occurring for many Hollywood stars.  I thought that if the most rich and famous people were getting these results that something must be missing in this field.  This lead me to gradually concentrate my interests into the field of beauty and specifically the ideas of beauty. The question I wanted to answer was ” what makes a face beautiful’?  Surprisingly, I found that no one really knew.  Our ideas of beauty were based on what is known as the neo classical canons.  These are rules of beauty that were brought down through the ages but originated during greek times. The were termed “neo” because they were revised during the renaissance and by Leonardo Da Vinci in the 1400’s.  I was shocked to find out that our rules of beauty had not changed much since the 1400’s.  If you read my paper you can find out about what some of the rules were at http://www.drphilipyoung.com/pdf/circles_of_prominence.pdf.  But essentially they are dogmatic rules based on external landmarks that I found occupied very little time when a viewer looks at a face when it analyzes it.  This question lead me to this journey of finding what beauty is and how to attain it for my patients.  During residency in Head and Neck Surgery, I applied for a Facial Plastics and Reconstructive Fellowship.  I was chosen among many candidates to train at Shreveport, Lousiana under the famous Dr Frederick Stucker, one of the grand masters in this field.

Thanks for reading, Dr Young

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

What are some characteristics that are attributed to someone that is Beautiful?

January 6th, 2010

This is another blog talking a little about how Beauty can impact our lives.  Did you know that people that are beautiful have many attributes attributed to them just based on their looks.  The reason people do this is somehow to simplify their lives when they face people who they don’t know.  Attributes like honesty, moral goodness, personality, intelligence, wisdom and many other positive personality traits are thought to be present in people that are better looking bestowed on to them by the observer.  This has a tremendous impact in many things.  When people are considered for hiring for a job, the employers and the ones that are doing the hiring are more likely to hire the candidate that is more beautiful.  This power of beauty pervades are lives in so many aspects.  Beauty moves our world with tremendous power.

Thanks for reading, Dr Young

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

My Journey to Find and Attain Beauty

January 6th, 2010

I wanted to start writing about my personal views and experience on my journey to find and attain beauty.  This is my first post regarding this subject and this will be an introduction for this category on my blog.

Beauty is one of the most powerful things in our universe.  I argue that it is the most powerful thing in our lives.  It is more powerful than politics, work, school, almost anything.  Wars have been started because of it.  Can you recall the story of Helen of Troy that was recently depicted in a recent Brad Pitt Movie.  Our world history is moved and shaped by Beauty to a large degree.  Remember, John F Kennedy and his victory over Nixon who was an incumbant president during war times.  The odds are the incumbant president usually wins.  Many believe that John F Kennedy’s win was largely due to his good looks and his charisma.  Kennedy lead one of the most powerful nations on the planet.  Beauty=Presidency=Major historical events.  Did you know that a 3 month old child is more likely to stare longer at pictures of better looking people than at people that are less good looking.  Did you know our mothers are more likely to check on their children left alone in the grocery cart when they are have better looks.  School children are given better grades when they are more beautiful while these differences largely disappear when they these children are compared by standardized tests. This power of beauty continues on through college, work, marriage and to the end of our lives.  This is why I have found this enigma, beauty, so fascinating.  This is why I have dedicated my life’s work to finding out what it is, how it changes our lives, and through my profession, how I can attain it for my patients.

Thanks for reading, Dr Young

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

What is a good option for something in place of Sculptra? What are the alternatives?

January 6th, 2010

Fat injections are the best option as an alternative to Sculptra injections. I even consider fat injections first before Facial Fillers. Nothing is better than using your own tissues for plastic surgery purposes.  You have essentially no risk for reactions, no risk for cancer, no toxicity from your own tissues. Sculptra is made up of suture material. It is a foreign substance that is essentially broken down into carbon dioxide and glucose and ultimately carbon dioxide and water.  Other ways of filling is through silicone implants. The problem areas for implants and Sculptra is the periorbital area.  Implants are also hard to use for the buccal area where there is no bone for the implant to rest on.  It is here that Sculptra can be used and Fat injections.

Thanks for reading, Dr Young

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