Is a chin implant the only way to augment the chin and how does a person occlusion fit into all of this?

October 15th, 2009

This was a question I answered for someone recently:

It all depends on your bite.

Edward Angle was the first to classify malocclusion. He based his classifications on the relative position of the maxillary first molar. The mesiobuccal cusp of the upper first molar should rest on the mesiobuccal groove of the mandibular first molar.

* Class I: Here the molar relationship of the occlusion is normal or as described for the maxillary first molar, but the other teeth have problems like spacing, crowding, over or under eruption, etc.
* Class II: (retrognathism, “overbite”) In this situation, the upper molars are placed not in the mesiobuccal groove but anteriorly to it. Usually the mesiobuccal cusp rests in between the first mandibular molars and second premolars. There are two subtypes:
o Class II Division 1: The molar relationships are like that of Class II and the anterior teeth are protruded.
o Class II Division 2: The molar relationships are class II but the central are retroclined and the lateral teeth are seen overlapping the centrals.
* Class III: (prognathism, “underbite” or “negative overjet”) is when the lower front teeth are more prominent than the upper front teeth. In this case the patient has very often a large mandible or a short maxillary bone.

If you have malocclusion, orthognathic surgery (jaw surgery / oral maxillofacial surgery) could improve your chin position especially if you have a class 2 occlusion where the top jaw is more anterior than the bottom. Correcting this can project your chin forward.  If you have a Class one occlusion, and your chin is still posteriorly situated you have what is called retrogenia, or microgenia and a chin implant could improve the appearance of your chin.  Sometimes correcting a malocclusion can still leave you with a small chin and an implant may still be needed. Genioplasty is the actual movement of the bone in a forward and inferior direction to increase the chin size vertically and horizontally.  Chin implants (or chin augmentation, chin enhancement , facial implants, genioplasty, sliding genioplasty, chin surgery, chin plastic surgery, chin cosmetic surgery) can only increase the vertical dimension approximately 2mm anymore usually has traditionally required a genioplasty.  Although there are custom implants that can give you more vertical height of your chin.  Genioplasty is a significant surgery and many people feel it is more work than worth the recovery.  Chin implant recovery is much less than a genioplasty in most hands.  You should come in to discuss this with someone qualified to consult you about this.

Thanks for reading, Dr Young

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

Posted in Chin Surgery | Comments Off on Is a chin implant the only way to augment the chin and how does a person occlusion fit into all of this?

What is best a neck lift and submentoplasty? Which is best to use for neck laxity.

October 15th, 2009

They both can mean the same thing. So you should talk to your doctor and ask him to tell you specifically what he means when he used each of those terms.   A submentoplasty doesn’t have a definite meaning specifically assigned to it.   Since it is part of the neck, I consider it a neck lift or a type of neck lift (or submentoplasty / necklift / platysmaplasty).  Sometimes, surgeons differentiate a submentoplasty as a procedure which is limited to an incision under the chin.  This could be applied to someone that doesn’t have a lot of laxity and someone who has minimal improvement to achieve (or turkey gobbler / neck laxity / neck banding / platysma bands / double chin / turkey waddle / fat neck).  Under this condition, you could limit most of your procedure to the incision just under the chin.  This does make things more difficult for the surgeon however.  Manytimes to make the skin adhere tightly to the new structure created under the chin, you really need to dissect the neck planes and tissue all the back to the hairline and down further.  This is always needed but the more significant the laxity the more you need to dissect posteriorly to allow the skin to redrape.  When you need to dissect more posteriorly, an incision behind the ear becomes more and more necessary.  When you start making incisions behind the ear, it is wise to consider tightening up the neck muscles in this part of the procedure and this is the portion that most people start calling it a neck lift. Personally, I like employing both approaches to ensure that the neck is a contoured as possible.

Thanks for reading, Dr Young

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

Posted in Necklift / Neck Lift / Platysmaplasty / Turkey Gobblers / Neck Bands | Comments Off on What is best a neck lift and submentoplasty? Which is best to use for neck laxity.

What is the best to replace volume in the upper cheeks filler or fat injections?

October 3rd, 2009

Both are good options with positives and negatives. Facial Fillersused for the upper cheeks include radiesse, restylane, juvederm, perlane. These are temporary. Radiesse should only be used in the deeper planes of the cheek especially around the lower eyelids.  The white appearance of radiesse can be seen through the thin skin of the eyelids if you are not careful and place it too superficial. The others are hyaluronic acids and they are clear looking and can be place almost anywhere.  Because they are clear when they are injected into areas of thin skin, your skin can take on a translucent look and sometimes this can look like a very light bruise.  They are fairly easy to put in and you can get relatively quick results but they are temporary lasting anywhere from 6 months to a year or more. Restylane lasts about 6-9mo, juvederm maybe a little longer but it comes supplied with less material 8cc compared to 1.1cc of restylane. Radiesse lasts about a year sometimes more or less.

Fat injections however can last for many years.  Usually you can get approximately 60-90% of the fat to survive depending on how well you do the procedure. Because it is a living tissue technique is vital to insure survival of the fat.  When carefully placed fat is the most naturally looking of all filling or volumizing type of 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 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.

Thanks for reading, Dr Young

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

Posted in Fillers / Facial Fillers, YoungVolumizer | Comments Off on What is the best to replace volume in the upper cheeks filler or fat injections?

Are Botox results permanent and can they be permanent?

October 3rd, 2009

Botox (dysport / botulinum toxin / wrinkle remover / bo tox / disport) results are temporary.  Botox binds on to the part of the nerve that releases neurotransmitter into the space that eventually blocks muscle contraction. Your nerves eventually regrow though and that determines how long botox lasts which is around 3-6 months.  The more botox you do the more that your muscles get weaker over time and hence the results of botox has the potential to last longer.  But they are never permanent.  There are ways to take away or clip specific nerves to get the same results  but longer.  Also there is a radiofrequency technique that targets specific nerves for longer results than botox.  The technique basically damages specific nerves so that they don’t lead to contraction of certain nerves that cause wrinkles.

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 | Comments Off on Are Botox results permanent and can they be permanent?

Microdermabrasion is generally more superficial and lasers can be more aggressive

September 30th, 2009

This is a question that I answered from someone:

I am confused between Laser Resurfacing and microdermabrasion. I have lines on my face which are not at all deep and I want to get rid of them. What should I do?

Microdermabrasion can help very small lines gradually improve over time.  This procedure is done through a machine that uses diamonds or crystals to take the superficial layers of the skin away.  Varying the pressure and the number of passes with the microdermabrasion can make it more or less aggressive.  The more aggressive the more results that you can attain. The laser resurfacing, such as with co2 lasers, can be the most aggressive of them all except maybe when you compare them with dermabrasion and phenol peels.  Laser resurfacing can handle some of the deepest wrinkles and scars that microdermabrasion would not be able to improve significantly.  Co2 resurfacing entails using co2 gas and the laser it produces to ablate the progressive layers of the skin.  The small lines that you have can be improved by microdermabrasion, chemical peels or co2 resurfacing.  The more aggressive you are with each modality the more results you will get. I use active fx / deep fx from lumenis lasers.  In terms of which one to do, it really depends on how deep the lines are and how much downtime you are willing to take.  The deeper and the more downtime the more aggressive you can be.  The progression starts with microdermabrasion then to null (lighter to stronger) and then to co2 resurfacing / or erbium yag 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 Chemical Peels, Laser Resurfacing, Microdermabrasion | Comments Off on Microdermabrasion is generally more superficial and lasers can be more aggressive

Fat is taken from another part of the body and transferred to an area that needs volume

September 30th, 2009

Fat transferring entails taking fat from some area of the body where fat is not wanted and then transferred / injected into an area that is needed or where volume is needed.  Usually very small puncture holes are needed to achieve great results.  This procedure is highly technique dependent.  Proper technique can make the results last for years.  Attention to detail is a must.

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 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.

Thanks for reading, Dr Young

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

Posted in Fat Transfer / Fat Injections, YoungVolumizer | Comments Off on Fat is taken from another part of the body and transferred to an area that needs volume

Can radiesse / radiance be used in the Jawline and lateral portion of the Jaw area?

September 27th, 2009

Radiesse can work but you may need a bit more in this area. Radiesse is made of calcium hydroxyapatite, the same constituent as your own bone.  This makes it really compatible with our bodies. For Mandibular augmentation, you will likely need a siginificant more amount of augmentation here than you would along the mouth lines.  Mandibular silicone implants are made up of approximately 10-15cc each side. So you will need quite alot of radiesse to show the same amount of change.  This is important to know before doing radiesse injections in this area.  If you just want to get a little taste of what this will look like then radiesse would be a good trial.  Silicone implants are one of the better ways of really augmenting the lateral jaw bone.

Thanks for reading!

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

Posted in Facial Implants, Fillers / Facial Fillers, Radiesse | Comments Off on Can radiesse / radiance be used in the Jawline and lateral portion of the Jaw area?

When do you decide to do rib, ear or nasal septal cartilage and what are the options for raising your nasal bridge?

September 22nd, 2009

Cartilage grafting is the best way to augment the nose during Rhinoplasty(or nose job / plastic surgery of the nose / cosmetic surgery of the nose / rinoplasty / nose plastic surgery). It is the least likely to have infection and rejection issues. The progression of cartilage grafting is usually nasal septum, ear cartilage, then rib cartilage. Septal cartilage is the most accessible but often is limited in quantity. Significant nasal bridge augmentation may require more than what the septum can offer. Ear cartilage offers more but the bend in ear cartilage makes it less attractive for the nasal bridge but can be used for small augmentations. Rib cartilage usually is needed when the nasal bridge needs to be raised a significant amount. When you start to consider the whole nasal bridge and if it is more than 2-3mm in change, you should start to consider rib as an option. You can also consider a silicone implant. Although this is a foreign object the rejection is really low if the implant is done right.  There are limits to how big you can make your nose.  The limiting factor is the skin envelope and the lining of the nose.  Making it much bigger than what it used to be is hard.  There is really no science that is out there yet to determine how much bigger one can make the nose.  An adequate release of the tissues to allow the rib or other graft to expand the skin is necessary.

Thanks for reading, Dr Young

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

Posted in Rhinoplasty / Nose Surgery / Nose job / Nose Reshaping / Nasal Reshaping | Comments Off on When do you decide to do rib, ear or nasal septal cartilage and what are the options for raising your nasal bridge?

What are the options for reducing the size of your pores. Does a facelift work for this?

September 17th, 2009

This is a question that I answered for a client who had questions regarding whether a facelift would work to reduce the pore size as well as acne scars:

Fat grafting, laser resurfacing, ipl are better options than a facelift (face lift/ lifestyle lift / quick lift / lunch time lift / mini lift / weekend lift / s lift / lifelift / thread lift ). Some newer studies and results from physicians more recently are showing that these modalities may be more beneficial to reduce pore size for people.  A facelift will not effectively do this but it can improve your wrinkles to an extent.  Fat grafting (or fat transfer / fat augmentation / facial fat transfer / fat injections) has been shown by some to regenerate the skin including reducing the size of your pores.  Stem cells in the transferred fat can rejuvenate the skin for years.  Laser resurfacing through the creation of new collagen can also reduce the size of the pores as well.  Ipl is another newer treatment for pore size.  Out of all the options fat grafting might be the best option for pore size and acne scarring.  More and more surgeons are using fat grafting as a way to improve acne scarring.

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 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 your case, the Younglift could help fill in the acne scars and volumize your face which will reduce your pore size

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, Facelift / Face Lift / S lift / Mini Lift / Weekend Face Lift / Quick Lift / Image Lift, Fat Transfer / Fat Injections, Laser Resurfacing, YoungVolumizer | Comments Off on What are the options for reducing the size of your pores. Does a facelift work for this?

Reducing the length of the ears without pinning the ear back with otoplasty

September 17th, 2009

This is a question that I answered for someone:

It really depends on what is causing your ears to look long. If it is your earlobe, your earlobe can be made smaller through different techniques associated with otoplasty (ear shaping / ear pinnning / ear plastic surgery / ear cosmetic surgery / large ear surgery)..  This is the most common cause for long ears.  Sometimes losing the volume in your ear lobes can cause the skin to hang down.  Adding tissue back can improve this appearance.  There are also ways to take some of the extra skin away so that the earlobe can look shorter.  If the ear is longer above where it curls. There are ways to take away cartilage so the it reduces the length of the ears.  A great way to know would be to see some pictures.

Thanks for reading, Dr Young

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

Posted in Otoplasty / Ear Reshaping / Ear Shaping | Comments Off on Reducing the length of the ears without pinning the ear back with otoplasty

« Older Entries
Newer Entries »