Monthly Archives: May 2011
Is it possible to make my smile not as wide?
Photo courtesy of smileplus.wordpress.com
“Hi I am 20 years old, when I smile or laugh my mouth opens very wide so it seems that my smiel goes from ear to ear! is there anyway to fix it so when I’m laughing, my mouth won’t open as much?”
This is a significantly delicate and tricky proposed concern. Overall there is not a recommended surgical procedure. However, based on your anatomy there is a possibility that some expertly placed small degree of Botox can diminish some of the widening of the smile. However, nonetheless this has to be done, performed and assessed by a physician who does a significant amount of Botox treatments. Overall, I think that it is important to get a good opinion from a physician as to whether anything, if at all, should be done. Try to trust the opinion of the physician that you consult with and if you have a trustworthy physician and a physician who is well recommended and if this physician says don’t have any procedures done then importantly you should listen to this recommendation.
Is It Uncomfortable to Have Upper Eyelid Surgery with Just Local Pain Medication?
Photo courtesy of blog.abcmedicaltourism.com
Rebric in Albertville, Al asks:
“I will be taking one hydrocodone/apap 7.5/500mg tablet and one diazepam 10 mg 1/2 hour prior to the surgery and given a local numbing injection. Do you know from your experience if this a comfortable option compared to general sedation? Plus have you performed this surgery without the protective eye lens cover?”
Too Young for Facelift and Cheek Implants?
Photo Courtesy of Dr. 90210
Sammzie in Berkeley, CA asks:
“ I’m 20 years old and I’m unsatisfied with the way my mid-lower face appears. I think I’d benefit from getting a mid-face lift with cheek implants. Am I too young to be getting these procedures done? “
Facelift surgery can be performed as early as early 30s, all the way into 80s and late 80s. Each individual is quite unique and each individual has different concerns and potential benefits. This is exactly where experience is extremely key to achieve the best result based on the individual patients concerns. For instance, a young individual with a good deal of adipose deposition or fatty changes to the face can benefit from liposculpture and sometimes some “tightening” (a form of facelift). But on the other hand, it is important not to jump in to have a facelift too soon as it is only in the instance of potentially achieving a real improvement is a facelift or mini facelift warranted. Essentially if an individual is properly motivated even at a young age and if there are moderate changes that could benefit from facelift then facelifting could be entertained. It is not an issue of age so much as it is for motivation, expectation and overall potential benefit determined by an expert facial plastic surgeon. The most common time period whereby individuals desire and benefit from a facelift is in the 50 to 65 year age range, but there are a number of patients who really do benefit in their early 40s. – David Santos MD, FACS
Subtle Change, Natural Result: Halle Berry
These pictures suggest a subtle improvement to the bridge of the nose and an even more subtle thinning of the nasal tip. I think the result is good and natural. She has a little more softer appearance, more feminine. Yes it is perfectly fine to keep what you have and not change a thing, especially when you are Halle Berry. But this is a personal decision, and she has had a good change for the better, and it probably feels good about this change. There are risks to rhinoplasty, and up to 15 % of nasal surgeries require a touch up treatment. ”Ethnic noses” are a little more of a challenge to get a natural result. -Dr. Santos
Neck Lift: Still Have Thick Tissue Under Chin
Photo Courtesy of Ralself.com
vwbusmama in California asks:
“I am 8 weeks post op after having a neck lift with platysmaplasty. I had a lot of fluid build up in the center of my neck after surgery and the doctor shot steroids into it twice. I still have a lot of thick tissue under my jawline. It is especially apparent when I look upwards. I have been massaging it but it doesn’t seem to get better. I’m concerned because everything I read from the doctors seems to suggest that healing is complete after 2-4 weeks. Can this thickening be permanent?”
Underneath the chin is probably the most challenging area to resolve problems with neck lift or facelift type surgery. Essentially in most instances liposculpture is required, as well as some form of tightening, tightening to the platysmal bands and deeper fascial muscle tissue. Many times incisions in the submental area are required to address this somewhat delicate area. In many instances the area can be quite satisfactory in the early postoperative period, but there are a high percentage of instances where fullness and firmness in this area is present a month and even two months postoperative. I think of three months as a reasonable time period postoperative to assess the result in this area, although sometimes even longer time frames such as six months or a year are required. Treatment modalities to this area include on occasion steroid injections, as well as bandage application for firm pressure on the area to assist with the healing. But nonetheless, two months is not unusual to still have fullness in this area. Revision true procedures to this region range from 1% to 10% in frequency, but the decision for additional procedure should be addressed no sooner than the six month mark. Nonetheless at two months further patience is required.
- Dr Santos-Facial Beauty.com
Plastic Surgery outside the US-beware glutathione IV treatment
The Food and Drug Administration recently declared that there are serious risks with the use of a popular intravenous skin whitener-glutathione, which has been in use in the Philipines. This is a medication only used out of the states for this cosmetic use. Glutathione comes from the liver and is an antioxidant. There is controversy as to whether or not it provides skin-whitening effects. The mechanism is through inactivation of the enzyme tyrosinase which is required in melanin production. The lighter pigment pheomelanin is produced instead. Utilization via the oral route is minimally effective.
There has been a large increase in the intravenous use of this drug, and generally this is provided at high doses intravenously simply to provide skin-whitening. This use is unapproved by the FDA and can result in significant deleterious health effects. Problems include kidney damage and failure, thyroid dysfunction, skin necrosis, and Stevens-Johnson syndrome.
The take home point is to really think twice about going abroad to have cosmetic procedures performed, and to stay away from unproven and non-FDA approved treatments.
Is It Safe to Have a Facelift After Sculptra?
Eimel in Gold Coast asks:
“I had a Sculptra injection and am supposed to have 1 more in 6 weeks, the doctor’s idea was to make my skin stronger so he can do a threadlift. After doing some research I think this is not for me and I’d like to go back to my original idea of having a traditional facelift – but I am now worried that if I get a facelift when my skin is a bit tighter from the Sculptra treatment it will sag again in 1-2 years once the Sculptra wears off. Can this be a problem after just 1 Sculptra injection?”
It is safe to have a facelift after Sculptra.
Sculptra is a quite successful filling agent that provides fullness to the face and lasts for a prolonged period of time. Some feel two years and some researchers and physicians feel that it lasts even longer. It is actually difficult to absolutely state the time that an individual Sculptra might dissipate, if at all. It does not simply go away completely at two years.
The best time to choose to do a facelift should not be influenced by when fillers such as Sculptra might wear off. When there are significant sagging components to the face, particularly jowls and neck area, the best remedy is for a facelift. Indeed many individuals undergo a facelift and also have concomitant filling, whether fat grafting, Sculptra or other fillers such as Restylane. This provides additional rejuvenation. If you have a facelift now, there will be changes over time that are for the most part unpredictable.
The best answer is to have a facelift now and as time goes along consider supplemental rejuvenation treatments as needed and as recommended by your physician, such as additional Sculptra or additional other fillers. On the other hand, if you wait for the Sculptra end point, when all the Sculptra is dissipated, the time period of this waiting period could be two years, could be several years and is unpredictable.
The New Face of Suzanne Somers
WHAT HAS HAPPENED
We see another transformation from one of the loveable people in whom we have watched so much over the years. Suzanne Somers is a beautiful woman and has been the likeable star of Three’s Company, and the leader of ThighMaster. She wants to keep her youth and beauty, she wants to look better.
When making this decision it is imperative to make sure that the plastic surgeon is board certified and has performed a good deal of the particular rejuvenation procedure. We do not know exactly what was done, but, these pictures suggest fillers of some nature. Fat grafting is the present day most popular rejuvenation filler although temporary fillers such as juvederm(R) or Restylane (R) are common as well. Her new look is very unnatural, grainy, doughy, sponge like. The best guess, as to what was placed, would be that of fat grafting.
With fat grafting the fat is harvested from the abdomen or thighs, and injected expertly into the face. Great care must be taken to place the fat in deeper tissues and to apply the right amount in the right places. Also expert techniques are required again, which further qualifies the importance of having a surgeon who has doe this a lot provide the service.
Generally, a good deal more of fat is placed in areas than ultimately desired, so that increased overdone bulkiness of areas treated is common and normal. Some studies suggest 30% of fat ultimately takes to provide the desired effect. We do not know how long it has been since Ms. Somers procedure and so there is real hope that the plumpness will recede over time. In fact if this was soon after the procedure she could actually have a good result, but this may be overly optimistic. Time will tell.
Nonetheless, if there was too much fat placed then it certainly will certainly ultimately look unnatural down the road.
We care about Suzanne and hope her the best.
FacialBeauty.com
David Santos MD
What is a Stem Cell Facelift?
Liquid facelifts, or injectables, and non-surgical facelifts have stimulated a great deal of interest. In limited scientific studies, stem cells mixed with hyaluronic acid have been injected into the laugh lines and shown to provide reduction in the depth of the creases. Further studies are needed, but there is a theoretical consideration that fat itself has stem cells within and therefore have unique aging prevention qualities. Fat injected in to the face or the back of the hands seems to do more than just feel in the crease- it can make the skin look younger. Fat grafting has become the treatment of choice for non-surgical face-lifts.
David Santos MD
Are you feeling the pressure to look younger? You’re not alone
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Are you feeling the pressure to look younger?
You’re not alone |
| Whether you are trying to keep your job, get a job, or just avoid aging like your parents, we all feel the demand to look our best. Several recent studies show that both men and women are concerned about their appearance and willing to take action to improve it.An interesting survey of 10,000 people by Sagamagazine revealed that people over 50 are more cognizant regarding their aging appearance, with 62 percent believing they are more likely to be judged on their appearance than previous generations. Cosmetic surgery has nearly doubled when compared to a generation ago. And men are now 14 times more likely to use anti-wrinkle cream, with 10 percent currently using some sort of age-defying serum.The Heat Group surveyed 500 female employees and found that onefifth of working women state they would consider cosmetic surgery to further their career. Approximately 30 percent reported discrimination at work based on their looks. And 40 percent affirmed that they knew of a co-worker who had been hired or promoted due to physical attractiveness rather than job performance. |
| According to facial plastic surgeons surveyed by the American Academy of Facial Plastic and Reconstructive Surgery, the latest trends in 2009 were people requesting cosmetic surgery to remain competitive in the workplace (80 percent agree), patients being more educated about plastic surgery (77 percent), and more use of non-surgical procedures to delay surgical procedures (72 percent).The most common non-surgical procedure for both men and women was Botox. Overall, these non-surgical procedures increased by 79 percent in 2009 compared to 2008 data. The economy most likely influenced the growing trend of consumers having less-costly, less invasive procedures. Also, there is a shorter recovery time, which often means more immediate results and a return to work the following day. Typical improvements include reducing frown lines (Botox), softening deep wrinkles (filler injections), and smoothing skin (laser resurfacing, chemical peel, or microdermabrasion).The most common surgical procedure for women was the facelift; rhinoplasty was the most popular procedure for men. Surgical cosmetic procedures increased by 13 percent and reconstructive procedures also increased by 31 percent in 2009.Obviously, you are not alone. Acceptance, accessibility, and affordability have played a role in the pressure to look younger. Today, it is more acceptable to fight against the aging process. Noninvasive treatment options have made taking action more affordable and accessible to a wider population. For more information, schedule a consultation appointment with your facial plastic surgeon.FIND THIS ARTICLE AND MORE IN THE AMERICAN ACADEMY OF FACIAL PLASTIC AND RECONSTRUCTIVE SURGERY (AAFPRS) ONLINE MAGIZINE |
