Are you considering a plastic surgery procedure?

Do your own research do not rely on websites, Yelp, and choose a surgeon because they have the most You Tube videos.

Here are the Top Questions to ask your surgeon.

1. What is the surgeon’s credentials and what certified boards to they belong to? The official site is The American Society of Plastic Surgeons, www.plasticsurgery.org  The American Board of Plastic Surgery www.abplsurg.org  There are additionally local boards that surgeons belong to in the city where they practice. Fellowships and training are also important information and should be taken into consideration as well as teaching positons, and published articles in peer reviewed literature rather than mass market books.

2. How many years have you been practicing?

3. How many procedures ( Your procedure) have you performed in the last 10 years? Look for at least 2-3 per week.

4.  Where are your hospital privileges?  Is your surgery center accredited? What is the accreditation and ask for a tour.

5. Are you licensed in another state? If so where? (There are websites where you can check to see if the surgeon has any malpractice or negligence suites, or whether his license has ever been suspended). You have every right to question this.

6. What is your revision policy?

7. How many revision surgeries do you perform on your own patients?

8. Ask for current before and after pictures. Have they been re-touched?

9. Can I speak to a patient who has had the same procedure that I am interested in?

10. What type of anesthesia do you prefer and why? Who is your anesthesiologist?  Ask about their credentials.

11. What can I expect realistically for my recovery time?

12. How do you handle complications?

13. If you are planning on going to a surgeon out of town find out their post-op care plans, whether they have hospital privileges, and who will be following up with you.

You only have one face and body!!

With new shows like Bridalplasty and media coverage on Mommy Makeovers.  I  predict that there will be an increase in Liposuction, Tummy Tucks, Breast Augmentation; all trending younger.  The 30- something and 40- something group is already trying Botox, Dsyport and  Xeomin and using fillers especially for lip plumping.

For nonsurgial facial rejuvenation HA Fillers, such as Juvederm, Perlane, Resytane will continue to be popular. Since HA fillers are temporary, consider them a great alternative to permanent fillers. If you don’t like the look, you can always have it dissolved with a product called Hyaluronidase, which is safe to use.

For those of you that have filler fatigue and are tired of getting fillers every 6-9 months there are longer lasting fillers such as, Sculptra, Radiesse, and soon to come to market Voluuma ( a longer lasting HA), currently be offered in the UK and Canada.  For permanent fillers try Artefill or Fat Grafting.

The trend in facial surgery is also getting younger, which makes sense. Your skin has more collagen and ellastin in your 40′s than 50′s or 60′s. A facelift should last longer than if you had your first lift in your 50′s. Since the neck is the fist to go and the most difficult to fix, having a facelift younger makes sense.

Rejuvenating with Stem Cells is a new area that will start to gain momentum as more surgeons start to offer stem cell rejuvenation. Companies such as Cyro-Lip actually can freeze Fat Tissue from liposuction, which is very rich in stem cells to later inject it into your face as filler. Younger stem cells will rejuvenate your skin.

It will be an exciting year in aesthetics..

This has been a very popular post throughout the year.  So, I decided to post an update.

While I did not have deep hollows, fullness in the eye hollow area or tear trough gives you a  more youthful look.

I  had seen the work of a local plastic surgeon and decided to had my eye hollows filled. His choice of filler was Juverderm which surprised me because Restylane seemed be a preferred filler for this area. Since I had seen other patients who had their eye hollows filled by this PS, I trusted his judgment.  The Juevederm made my eye area very puffy and I was quite bruised. I went back to the same doctor and he concluded that he should dissolve some of the filler with hyaluronidase and start fresh with Resytlane, which he should have used to begin with.  The hyaluronidase worked great. I went back a week later and he injected a small amount of Restylane under each eye.  I came back a week later and he decided that his nurse (RN) might have better luck, as I still needed tweaking. Indeed she did. She was quick and precise. The entire process took around 4 weeks to resolve.  I was quite bruised for several weeks. It has been over a year now and I have just started noticing that my eye hollows are in need of filler again. I would not go back to the same PS for the filler, as his RN no longer works there.

Conclusion: Is it worth it?  Yes- if you have an experienced injector, who routinely injects the eye area.

Do you dislike those hollows in your lower eyelids or the dark circles under your eye?

Many people are choosing to get treatment for this area with either Juvederm or Resytlane.

JUVÉDERM® is a smooth consistency gel made of hyaluronic acid – a naturally occurring substance in your skin that helps to add volume and hydration. Restylane® is also an hyaluraonic acid used to add volume and hydration.  Both fillers can be used to fill the eye trough area- but with caution.

I have been reading many online posts from patients who have had both fillers and have experienced puffiness, lumps, and a baggy look after the injection. Others have had good results. What is clear after reading the  many posts and talking to others is that you must be very cautious when making this decision.

Performing “tear trough” treatments to the hollow area under the eyes requires meticulous technique and can be a very satisfying treatment when done correctly.

Here are some guidelines to consider before you jump into filling those hollows under your eye:

1. Go to a board certified surgeon or  an oculoplastic surgeon.

2.Ask him/her how many treatments they have preformed. Proper injecting into the site is key for good results. If the filler is not injected deep enough it can leave lumps,  pillows or pockets of puffiness.  If too much is injected it can  also cause puffiness.  This is such a very delicate area to treat.

3. Ask to see before and after pictures.

4. Ask the doctor if you are good candidate for this procedure. As we age our skin thins. It is easier to treat  younger skin that is not so thin. Bruising is common plus one could get permanent discoloration as hemosiderin pigment is left behind.

5. Plan on being bruised for 7-10 days. I would not plan to have this done before any event or vacation.

6. Take SinNeech or Arnica before and after the treatment. There are also pre/post injection formula capsules made by GliSodin.  I would highly recommend starting them before treatments.  www.glisodinskin.com

Taking these supplements will help  you heal faster with less bruising. Do not take ibuprofen or St John’s Wart, Fish Oil and Vit E for a least 3 weeks before your treatment.  If in doubt ask your physician what not to take prior to the treatment.

The good news is that there is a medication called Hyaluronidase injections and these can dissolve the Juvederm or Restylane. The filler will dissolve in a few days rather than months. Depending on how much filler you need to dissolve, you may need to go back for additional injections. A competent surgeon should not charge you for his or her mistake.  Ask if you will be charged should you need the treatment to be reversed. You  already probably spent between $600-800 for the treatment.  If you do need it reversed, hopefully you will not need all the filler dissolved, since it would be nice to have some benefit from the treatment and the money you just spent!

I think that if physicians are going to continue to treat the tear trough area, proper training is imperative. From my experience not all surgeons are good injectors.  With injectables- technique is key for good results.  Plastic Surgeons and physicians  preforming these treatments could benefit from more training in this area.

Fillers for eye hollows is not FDA approved, which is OK since many anti-aging treatments are being used off-label. However, if there are more negative outcomes than positive- perhaps it is time for the FDA to step in or for the dermal filler companies to be more responsible.

In the end it is your decision – base it on good information and a referral from someone you know and trust.

Perhaps soon, there will be a dermal filler more suited for this delicate area.

Filed under: Aesthetic Medicine and Treatment, Anti-aging Treatments, beauty, Liquid Facelifts Tagged: eye hollows, fillers under eye, Juvederm, Restylane, tear trough, treatment for eye hollows, woman's health, woman's wellness, wrinkles ]]> http://beautirx.com/2011/12/24/filling-the-eye-hollow-with-dermal-fillers-what-are-the-risks/feed/ 9 mychelg restylane_undereyes http://beautirx.com/2011/12/19/top-10-tips-for-choosing-skincare-products-that-work/ http://beautirx.com/2011/12/19/top-10-tips-for-choosing-skincare-products-that-work/#comments Mon, 19 Dec 2011 21:17:33 +0000 mychelg http://beautirx.com/?p=1331 Continue reading »

http://fightfinelines.com/2011/05/19/top-10-tips-for-choosing-skincare-products-that-work/

“No more wrinkles in 6 days” ….“See the reduction of fine lines in less than 10 days”… “Dermatologists tested” “Clinically Proven” “Clinical Studies”…

Buyer beware. Magazines are full of claims from manufacturers touting new technologies and advances in skin care products. There is so much marketing hype today around skin care products that promise results, that it’s hard to know what really works.

If this wasn’t confusing enough, we are now in an age of ever-emerging new technologies and anti-aging breakthroughs. From “micro-beads” to stem cells, products are getting more and more complex both in what they’re made of and also how they are delivered to your skin. As exciting as this seems, it’s also questionable whether or not these new advances are really going to live up to their claims.Cosmeceuticals, high-end “Dr” brands, and everyone under the sun claiming to have the latest skin care can leave you   searching for the next best thing before you even get to the register. Even with seemingly potent active-ingredients, there is little regulation on what claims companies can make. You have to wonder, was the entire formulation tested or just the active ingredient? Who was the product tested on? If it was tested in a lab, how do we know it actually works on human skin cells?

So, what should you be on the lookout for to help you cut through the skin care product clutter?

Before you buy your next face cream, cleanser, anti-aging lotion or brightener know what you are buying, and from whom you are buying it.

Try these 10 Tips for your next skin care shopping trip:

1.  Your skin care needs change with age, buy accordingly.
2.  The normal cell cycle is 26-42 days, this cycle actually lengthens as we age and skin thins as we mature. Recognize the hype for fast acting wrinkle cure skin care products. They can only go so far…
3. Physician brands, which are sold in the physician’s office, have stronger active ingredients than mass-market store brands. Don’t be confused by a doctor’s name or “MD” on a mass-market brand. These brands are still made with lower percentages and strengths of important ingredients.
4. A medical esthetician or dermatologist has the training and knowledge to prescribe a good skin care routine for you. Manyplastic surgeons offices also offer expert advice on medical-grade skin care products.
5.  Ask questions and read up about studies, ingredient strengths and percentages of ingredients.
6.  Alpha hydroxy acids (AHA) remain at the top of the list for fighting fine lines, improving the tone and texture of skin, and for excelling at exfoliation. Glycolic acid  and glycolic compounds are two highly effective AHA’s due to their very small particle size which allows them to penetrate deep into the skin.
7. Nanotechnology is a current buzzword used in products. This technology reduces the molecular size of the ingredient to penetrate the skin better. This technology is still new, so stay tuned!
8.  Look for products that build collagen such as Retinol, Vitamin A, Hyaluronic Acid, or Tretinoin (prescription).
9. Buy products that contain anti-oxidants such as Vitamin C, 
L-ascorbic acid, Vitamin E, Coenzyme -Q-10,(ubiquinone), Alpha lipoic acid,  and Ferulic acid. They prevent fine lines,  help fight off wrinkles, and are perfect
   for plumping the skin.
10.  Use products with brightening agents to diminish dark sunspots and discoloration. Such agents include, Hydroquinone, Arbutin, Kojic Acid, Niacinimide, Azalaic acid, TCA, Green Tea (EGCG), and Licorice extract.

Do your homework and don’t be fooled by the hype to make sure you get the most bang for your beauty-buck.

HAPPY SHOPPING!

Featured in  MAS | MAY 19, 2011

Filed under: Beauty and Skin Care Products, Cosmetic Surgery Tagged: anti-aging, Fight Wrinkles, skin care ]]>

Many clinical studies have shown that micro-channeling (Needling) is more effective than other methods of treatment including laser resurfacing, chemical peels and microdermabrasion.

Micro-needling or micro-channeling uses a micro-needle roller to painlessly penetrate the epidermis in order to stimulate collagen and elastin growth and to create clear routes to increase absorption of topical serums into the skin. This system also benefits acne scars.

Micro-needing became popular in 2004-2005, however the theory of puncturing the skin has been around for a long time.  Have you ever punctured a zit?  Afterwards, the healing process begins.  Tattooing is also a form of micro-needling with a penetration depth of about 1.2 mm.

Histological findings of skin tissue that was microneedled with 0.5 to 1.5 mm long needles (according to facial skin thickness) revealed that they stimulated massive growth of elastin- and collagen fibres (in some cases up to 1,000%). The inventor called this form of microneedling COLLAGEN-INDUCTION-THERAPY (CIT in short). In the Nineties the Canadian surgeon Camirand used tattoo-guns without colour pigments to treat operation scars after plastic surgery. His intention was to perforate scars to take off their tension. They became softer and pigmentation sometimes came back. This post-operative microneedling technique soon disappeared from the operation rooms because it was a tedious job without income.

There are several micro-needling devices on the market for at home use.  One product such system  DermaFIT™ combines a dermaroller with a topical peptide serum to encourage the growth of collagen, elastin, keratin skin to give you a more youthful, smooth appearance.   What I like about this system is that it comes with a topical peptide that has been specifically formulated for micro-needling, plus a sunblock and instructions.  Your skin will be more sensitive to after each treatment. The roller is easy to maneuver and the needles  are .25mm.   It takes a little practice to learn how deep to press to the roller into your skin to get a uniform treatment.

The DermaFit is only sold to medical practices and spas, the aesthetician or MD demonstrate will demonstarte how to  it effectively for home use.

An at home micr-needling treatment will not take the place of an in -office micro-needling treatment with DermaFrac, a new micro-needling office treatment.

I will post an update on this treatment is a couple of weeks.

1. Clarisonic system is the easiest way to get your glow back. Used daily you will see a significant difference in your skin.  There are different heads that you can buy, depending on your skin’s sensitivity.  I love mine and have had it for several years. Definitely  worth the investment. Clarisonic prices start at about $125.00 http://www.clarisonic.com/ Note that some kits come with cleansers. There are many options in OTC cleansers. My recommendation is to buy the machine only, with extra heads.

2. Buy a cleanser that contains glycolic or lactic acid.  These ingredients create exfoliation and cell turnover. You can find many professional brand name products online.  Or ask an esthetician or dermatologist for a recommendation.

3. Use a OTC Retinol product or  Retin-A Rx or  Tazorac Rx are also good choices. Your skin will shed the old cells and build new cells. Start off with a low dose of .05%. Using Retinoids will  also prevent acne and blackheads from forming. Retinols build collagen and ellastin necessary for healthy, youthful looking skin.

4. Get a chemical peel 2x a year. Change of seasons is a good time.  Peel are sometimes given in a series, this will depend on how much sun damage you have.  Time the peel accordingly, because you may be red and peeling for several days. Once your skin has peeled you will be amazed at how youthful, healthy and glowing it is.  Go to a licensed esthetician, RN, or Physician Assistant  who works either in a medi-spa, dermatologist or  plastic surgeon’s office.  There are many chemical peels available today. There are superficial peels, medium depth peels and deep peels. The strength of the peel will depend on what results you are seeking, your skin type and how much down- time you are willing to take. TCA (trichloroacetic acid)  peels and Glycolic acid peels are the most popular.   Chemical peels are recommended for  Hyperpigmentation, Sun damage, texture, pre-cancerous lesions, acne, lines, mild wrinkles, lip Creases. There are pre-cautionary measures to take prior to having a TCA peel, check with your skincare specialist first.

GO GET YOUR GLOW!!

Is is wrong to want to look refreshed on the outside?

We are lucky to live in world evolving  anti-aging technologies. The choices are many- from  anti-aging skin care, to non-invasive treatments to surgery.  Is there a fine line between looking natural and overdone?  I think so.  You can look totally natural with a little Botox to soften frown lines or crows feet or on the other hand you can look frozen and unnatural. Fillers can  plump up the loss of volume in our cheeks and temple area giving a more refreshed look. Or they can overdone.

I started getting Botox injections in my early 40′s before its FDA approval. My  deep furrows are now gone from my forehead and  I go less often for injections.  My kids tease me that one day I will be in a nursing home begging for Botox.   I like not having deep furrows and frown lines.  I like  appearing younger than I really am , and at the same time I am proud of my  age. I don’t want to look  like I am 20 years old. Yet, I want to look as good as I can.

It’s all  about maintenance- I color my grey, shape my brows, use good skin care products, have chemical peels, get manicures and pedicures,  take vitamins, watch what I eat, exercise ( though not as often as I should) get my Botox fix, and fillers when needed.  Is this too much?  Perhaps some people may think I am obsessed.

You feel as good as you look.. and you look as good as you feel.. Maintaining your looks takes work.. and what is wrong with that? It’s not about vanity- it ‘s about feeling good!!

As Coco Chanel said,

“NATURE GIVES YOU THE FACE YOU HAVE AT TWENTY; IT IS UP TO YOU TO MERIT THE FACE YOU HAVE AT FIFTY.” COCO CHANEL

As I was watching  The Big C, the hit Showtime Original Series about living… with cancer-Melanoma, I decided to write this blog.

Melanoma is on the rise, it is the deadliest form of skin cancer if not caught early.  It is a horrible painful disfiguring disease. I know, my dad died from Melanoma which started on his scalp and metastasized though his body. He lost 1/3 of his neck to this horrible disease.

Children and you women are especially at risk.  Research also suggests that  higher income women and families are at greater risk due vanity and lifestyle.   According to the American Cancer Society Melanoma is thought to account for about 9,000 deaths per year in the United States. Many of these melanoma cases are avoidable through common sense measures such as limiting sun exposure.

The American Cancer Society has identified the following risk factors:* Unprotected and/or excessive exposure to ultraviolet (UV) radiation

* Fair complexion

* Occupational exposures to coal tar, pitch, creosote, arsenic compounds, or radium

* Family history

* Multiple or atypical moles

* Severe sunburns as a child

There are many steps we can take to prevent this deadly cancer.  There is a new FDA approved technology that can aid your physician in an early  diagnosis.  Ask you physician about scanning with MoleMate, the first FDA approved skin cancer screening device.

Some common sense steps include:

1. Wear clothes that cover your skin. You can also buy protective sun clothing.  Here is one brand to check out http://www.coolibar.com.

2. Wear wide brim hats or a baseball cap and sunglasses to protect your face and scalp.

3. Use a good physical block, SPF 30 or greater. Do not rely on SPF in your make-up or foundation.  Apply your sunblock often.

4. Boost your sunblock with a good Vitamin C cream or serum. Apply a Vitamin C  product underneath your sunblock.

5  Take Vitamin D3, which has been known to help protect against skin cancer together with an antioxidant to help against free radical damage.

6. Do not use Tanning Beds.  If you want to look sun- kissed apply a self tanner. There are many ones to choose from. they’ve come along way from the days of orange CooperTone.

7. Exam yourself. Visually check your body for any new or unusual sore or spots, a freckle or mole that has changed in color, size or texture, or a sore that does not heal. http://simsys-molemate.com/2011/08/09/examining-yourself-for-skin-cancer-is-a-vital-first-step-of-prevention/

8. Schedule a body mole check, especially if  you have risk factors or many moles.

9. Contact your doctor right away if you suspect something.

10. Don’t delay!!

T

You want to look your best.

Maybe you’ve been thinking about having a facial, a chemical peel, a little Botox, dermal fillers, Laser or IPL treatments. Since you want to look your best, you need to plan a schedule for these treatments allowing yourself the proper time for healing or any adjustments.  Don’t want until the week before your event.

Here are some factors to keep in mind when you make your appointments.

1. Schedule a series of facials at least 4-6 weeks in advance. If you have sensitive skin you could break out. The goal is for glowing, healthy skin before the big day.
2. If you plan to change skincare products, start 6-8 weeks before the event. Any change in products could cause your skin to react
3.  If you are using Retin-A products. Stop one week before the event, so you are not red or peeling.
4. Schedule any chemical peels at least 4 weeks before the event. You want your skin to glow-  not be red, flaky or peeling.
5.  If you are planning on having any Botox or fillers- take arnica pre-injection and post to minimize bruising
6.  Botox should be scheduled at least 2 weeks before the event. You may bruise, it takes 3-7 days to kick in and you may need to tweak the area.
7. Lip fillers- at least 4 weeks in advance. You may be swollen for 7 days and you really will not see the final effect for two weeks. Juvederm swells more than Resytlane, but Juvederm tends to last longer in the lip area.
8. Eye Hollows- at least two months in advance. You could have severe bruising in this area and puffiness. I would not take any chances. Two- three months of healing should be enough.
9. Dermal Fillers – Two to three weeks in advance. You may bruise, and have swelling. Plus if you need any adjustments you will have time. This includes, Juvederm, Restylane, and Radiesse.
10.  If you choose to use fillers such as Sculptra, you will need to start several months in advance, as this filler requires more injections and time to see results.
11.  Looking to rid of brown spots with IPL? Chances you will need to have several treatments, Start as early as six months in advance, this advice is the same for any type of laser treatment, even vein therapy.

If you have any questions, ask your dermatologist or plastic surgeon.

I am not going to give a definitive answer yet, however, these are my observations.

1. My chest area is still slightly bumpy, slightly pink and in the light you can still see the vertical lines from sleeping all these years on my side. It does look a little better and smoother.

2. Hardly any pink around my mouth area. I really so not see much difference here in the vertical lines. The technician was agressive in this area using both YAg and Ablative. I will discuss setting and depth in another blog post. I developed a very small hypotropic scar above my lip line, which I hope resolves. I am not sure why this happened- however, I apparently healed too quickly in this area. I also noticed that my lips looked flatter, consequently I felt like a needed to plump them.

3. My initial reaction is that Co2 Lasers are more effective in building collagen and go deeper.  This seems to be the gold standard. Cutera (http://www.cutera.com) is the manufacturer of the Pearl Fusion and it is not a Co2 Laser.  There is much controversy in the laser resurfacing arena.

So far I am not impressed with Cutera’s Pearl Fusion.  If anyone has had any laser resurfacing experience, I welcome your comments.