Light on Laser – CO2 Laser Resurfacing

February 15, 2012 in Non Surgical Options | Tags: , , , , , , , , , , , , , , | Leave a comment

Between laser light shows and sci-fi films, there can be many misnomers about the use of lasers when it comes to your face. Here’s to shining a light (or laser) on the topic…

What is laser resurfacing?

LASER is an acronym for Light Amplification by Stimulated Emission of Radiation. Laser resurfacing is a technique used to improve overall skin quality by diminishing fine lines and wrinkles. A high-energy laser beam is applied to erase sunspots and freckles while simultaneously tightening the skin, promoting collagen growth and vaporizing superficial damaged skin cells. Laser resurfacing is a non-invasive, incision-free procedure that requires little downtime.

At Oculus Specialty Surgery Center, we perform CO2 fractional laser procedures. When looking into laser resurfacing, I recommend the use of a fractional laser. “Fractional” describes the method used to deliver the laser to the surface of the skin, meaning only a fraction of the skin’s surface is touched. This method leaves microscopic portions of untouched skin, aiding in the most efficient recovery process possible.

Tell me more, tell me more.

We offer two forms of resurfacing: ActiveFX and DeepFX. The difference between the two is how deeply the treatment penetrates the skin’s surface. ActiveFX primarily treats the epidermis (outer layer of skin), whereas DeepFX penetrates to the dermis (middle layer of skin). These modifications are tailored to the individual patient. A combination of both ActiveFX and DeepFX is most common for someone who is getting a full-face laser treatment to optimize healing. During combination procedures, DeepFX is used on areas that have more visible lines (i.e., eyes, mouth, scars), and ActiveFX is then used on the remainder of the face. Spot-treatments on certain areas is also an option.

Before                                                                          After            

Before                                                                          After    

*Skin tone in shots may vary based on patients sun exposure and or makeup

Getting back out there

Healing from laser resurfacing takes about 2 weeks to look back to “normal,” however most people remain pink (like they’ve had too much sun) for 2-3 months. As healing progresses, the patient’s skin will continue to fade back to its natural color. Once healing is complete, people feel as though they look 5-7 years younger!

This healing process is easily covered with makeup after 5-7 days. Patients who have laser resurfacing have the opportunity to come into Oculus Skin Care Centre for a complimentary makeup consultation with one of our estheticians. We carry a line of mineral makeup specifically designed to camouflage and aid healing while achieving a natural look.

Is this right for me?

Candidates for this procedure would be individuals with acne scars, sunspots and facial wrinkling. Unfortunately, it is necessary to have moderate to light colored skin. Dark skin can heal in a hypopigmented (lighter) shade in comparison to the remainder of the body.

ALCAT: Are your favorite foods fighting you?

January 25, 2012 in Health | Tags: , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

ALCAT Testing: Sensitivity vs. Allergy

When people think of food allergies they often imagine a child getting a whiff of peanut butter on the school bus and going into anaphylactic shock. This is an example of a “true” food allergy, one that triggers an immediate histamine reaction that can lead to anaphylaxis. ALCAT (Antigen Leukocyte Cellular Antibody Test) is not an “allergy” test but a “sensitivity” test, measuring how food interacts with one’s individual immune system. Many of us are walking around everyday consuming items that may be inhibiting our ability to function at our highest self, without even knowing it!

The ALCAT test is a blood test that identifies reactions to over 350 foods, chemicals, molds and substances linked to inflammation. Inflammation may not sound detrimental initially, but it is linked to some of today’s most common degenerative diseases. You may be suffering from inflammation due to food sensitivities and intolerances if you experience:

Migrane Headaches

Chronic Fatigue

Fibromyalgia

Arthritis

Weight Gain and Obesity

Asthma and other respiratory problems

Attention Deficit Hyperactivity Disorder (ADHD)

Irritable Bowel Syndrome (IBS)

Eczema and other skin disorders

The tricky thing about food sensitivity, as opposed to allergy, is with allergy there is usually an immediate response to a stimulus, making it easy to pinpoint why you experience a reaction. With sensitivity, often symptoms are delayed (hours or even days), causing it to be difficult to pinpoint what specific item is triggering that response in your body, hence why the ALCAT test becomes a necessity. ALCAT is the most effective sensitivity and intolerance test currently available.

The ALCAT results are presented in tiers of suggested elimination:

Red category – indicates a severe reaction and items should be eliminated for a minimum of 6 months

Orange category – moderate reaction and should be eliminated for a minimum of 3-6 months

Yellow category – mild reaction and should be avoided if possible (especially if there are not many in the Red and Orange categories)

Green – foods listed as non-reactive and can be eaten freely on a rotation basis (no more than every other day)

*Above is a sample of test results

Because the ALCAT is your own personalized eating guide, the results can prove quite liberating especially for people that have struggled with mainstream dietary notions and fads with little success. It’s basically your own diet!

We have a number of inflammation issues in the Cole household, and the ALCAT was incredible in helping us key in on some of the dietary contributions that we hadn’t ever considered. I recommend it for anyone who considers how their diet affects their lives.

As a part of supporting our patients in healthy living lifestyles, we offer ALCAT testing at Oculus Skin Care Centre.  It is an easy and fast test that can be tagged onto any of your upcoming visits! Another perk: ALCAT testing is covered by most insurance plans. Check with our office for further details 404.256.1500

CHIP’S TIPS:

Eating a variety of foods and rotating frequently consumed items can help prevent sensitization and inflammation, so stay out of the rut with the spice of life!

The Benefits of Surgery: Camouflage vs. Corrective

January 11, 2012 in Uncategorized | Tags: , , , , , , , , , , , , , , , , , | Leave a comment

Injectables, topical products, LED therapy and other anti-aging treatments are clinically proven to encumber the aging process and are something I recommend for most patients. Unfortunately, non-surgical solutions can only do so much. Thus, there exists the dilemma of Camouflage (non-surgical) vs. Corrective (surgical).

Non-surgical treatments are often useful as bridge procedures to camouflage undesirable lines and sagging skin until one is ready to take a more permanent corrective step. Long-term and lasting results come with surgery. When you are considering coming in for your next non-surgical treatment I urge you to consider the benefit of going the corrective route. In my 25 years of experience, I have watched patients spend the same amount of money and even more time investing in non-surgical treatments as they could have spent having the area fully corrected with a surgical procedure.

Some of the most popular corrective surgeries I perform at Oculus Plastic Surgery are:

  1. Blepharoplasty (removal of excess tissue and skin from the eyelids)
  2. Ptosis repair (modification of drooping upper eyelid)
  3. Brow lift (stabilizes drooping brows and softens wrinkles on the forehead)
  4. Lower facelift (corrects and modifies loose skin and muscle on the lower face and neck)
  5. Mid facelift/cheek lift (elevates the sagging fat and muscles of the cheeks, fills the groove between the cheek and eyelids)

More interested in Camouflage? I also offer the following non-surgical remedies:

  1. Lip Augmentation
  2. Nasolabial Fold Augmentation (laugh lines)
  3. Cheek Enhancement
  4. Melolabial Rhytid Augmentation (marionette lines)
  5. Perioral Rhytid Augmentation (lines around the mouth)
  6. Tear Trough Deformity (sunken lower eyelids)

*Please find a complete outline of procedures and detailed information on my website www.oculusplasticsurgery.com well as before and after photographs on www.drcole.info

There are a number of possibilities to keep in mind when making a decision about whether or not a surgical enhancement procedure is the right choice for you.  I suggest seeing a qualified facial plastic surgical specialist such as myself to assist in navigating what treatments may be right for you. At Oculus Plastic Surgery we have a number of custom options individualized specifically to meet each of our patients’ needs.

The Injectable Decoder: Who? What? Where? Why? And When?

December 29, 2011 in Non Surgical Options | Tags: , , , , , , , , , , , , , , , , | Leave a comment

Injectables are a great way to obtain instant anti-aging results by smoothing unwanted lines and adding volume to areas where collagen has depleted. People often wonder what the differences between injectables are, where they can be best utilized and how long the effects will last. The following outlines popular products and how I most commonly use injectables here at Oculus Plastic Surgery. Let the anti-aging begin!

Botox Cosmetic® and Dysport® are the most commonly referenced injectable treatments for those who may be new to the scene. These products are ideal for patients whose primary concern is expression lines. Both products work by interfering with neurotransmitter activities, which subsequently causes the temporary relaxation of the muscle to which it is injected, creating a smooth and soft facial appearance.

Use:

  • Forehead lines
  • Crow’s feet
  • Nasalis wrinkles (wrinkles formed on the nose from squinting)
  • Glabella (frown lines located between the eyebrows)
  • Migraine headaches
  • Hyperhidrosis (excessive sweating)
  • Blepharospasm (spasms of the eyelid)

Length of stay: typically 3-4 months

Cost: $$

Juvederm®is made from hyaluronic acid which is a naturally occurring sugar found in soft tissues. The role of hyaluronic acid is to act as a cushioning agent, delivering nutrients and retaining water to hydrate and nourish the skin. Since Juvederm® is natural to the body, there is no need to test for allergies or sensitivities.

Use:

  • Adds volume and a smoothing effect to facial wrinkles (moderate to severe)
  • Is used for volume augmentation on tear troughs, cheeks, lips and chins

Length of stay: typically 6-12 months depending on if you are a fast healer or not

Cost: $$$

Restylane® is also made from hyaluronic acid and is similar to Juvederm®. While both act as volumizing fillers, Restylane® is the only filler currently FDA approved for tear trough augmentation.

Use:

  • Adds volume and a smoothing effect to facial wrinkles (moderate to severe)
  • Is used for volume augmentation on tear troughs, cheeks, lips and chin

Length of stay: typically 6 months

Cost: $$$

Radiesse® is made from calcium hydroxyapatite, which is a substance found naturally in teeth and bones. Micro beads are combined with a water-based gel and once injected, Radiesse® forms with dermal tissue to stimulate collagen growth.

Use:

  • Adds volume and a smoothing effect to facial wrinkles (moderate to severe)
  • Cheeks, chin and jawline for facial contouring and volume augmentation

Length of stay: Radiesse® is absorbed in the body overtime, however, the new collagen produced will remain, yielding long lasting results typically 12 months or longer.

Cost: $$$$

Sculptra® is made from a synthetic substance derived from the alpha-hydroxy-acid family. It is biocompatible (will not harm the body) and biodegradable (is broken down and metabolized by the body). This substance, similar to Radiesse®, forms a matrix with the tissue and stimulates collagen growth.

Use:

  • Adds volume and a smoothing effect to facial wrinkles (moderate to severe)
  • Cheeks, chin, temples and jawline for tissue contouring and volume augmentation

Length of stay: Areas of treatment require 2-4 sessions performed 3-6 weeks apart. Results from Sculptra® typically last 2 years or longer when a series of 3 treatments are preformed, making those multiple sessions worth it! Ideally, one “booster” every six months following the initial series will continue the results for years to come!

Cost: $$$$$

Keep in mind, you are not only paying for the actual product but for the expertise of the person that is administering the injections.  Choose a doctor, such as myself, that is well-educated about the musculature of the face.  I am honored to be a doctor that has been chosen to educate other doctors on the proper administration techniques.  Please call Oculus Plastic Surgery to reserve an appointment today! 404.256.1500

3 Essential Ingredients to Skin Care

November 30, 2011 in Fun In The Sun, Great Skin, Non Surgical Options | Tags: , , , , , , , , , , , , | Leave a comment

Human Growth Factors (HGF). Growth factors are naturally produced in our skin, and as we age HGF production declines. Products containing HGF essentially trick your skin into thinking you are younger, and therefore stimulate additional collagen production. The result is overall skin rejuvenation, most notably increased firmness and elasticity as well as improved appearance of fine lines and wrinkles.

 Female, Age 49 (left photo is baseline, right photo is after two months use of TNS Essential Serum®)Female, Age 54 (left photo is baseline, right photo is after one month use of TNS Essential Serum®)

Product recommendations: SkinMedica TNS Essential Serum®, SkinMedica TNS Recovery Complex® (Both products contain pure HGF)

 

Retinol. Retinol is the best over-the-counter ingredient used to reverse damage caused by exposure to the sun. I suggest starting out with a moisturizer or serum that contains .65% Retinol and adjusting the frequency of use depending on individual skin type. For preventing further sun damage, make sure to wear sunscreen with zinc oxide!

Product recommendations: SkinMedica Tri-Retinol Complex (0.65% total retinoids) SkinMedica Environmental Defense™ SPF 30+ (8% Zinc Oxide also contains antioxidants)

 

Antioxidants. Topical antioxidants act as free radical neutralizers, protecting your cells from harmful damage. If gone unchecked, free radicals are capable of degenerating skin tissue. Antioxidants will also improve the appearance of skin, particularly the tone and texture, while offering added protection from the Sun.

 Product recommendations: Oculus TeaDerma Pads, Jan Marini® C-Esta Serum

*Make an appointment for a complimentary Visia™ Complexion Analysis with one of our estheticians at Oculus Skin Care Centre to learn more about what products are best suited for your individual anti –aging needs! 404.836.3636

Visia™ Complexion Analysis: What Lies Beneath.

November 9, 2011 in Great Skin, Non Surgical Options | Tags: , , , , , , , , , , , , , , , , , , | Leave a comment

One of the first things we do each day is take a look at ourselves in the mirror.  It is easy to take a quick scan of your skin and note when things are not as they should be.  You may see a breakout, dry patches, redness, or a new freckle after your latest and greatest pool day.  It is becoming increasingly important to take note of and address skin concerns that you can’t see before they are a red flag in your morning once-over.  The Visia™ Complexion Analysis machine does just that.  It analyses your skin on the surface to show spots, texture, pore size, lines and wrinkles.  It then goes one step further to take a peek under the skin’s surface to look at current bacteria levels and sun damage that has yet to surface.  Sure that sounds a bit scary but it allows you to size up the enemy and take measures to make things better and keep the signs of aging under wraps. The process is simple and one that can be repeated over time so that you can actually see the evidence that dragging yourself out of bed to wash your face and re-apply your moisturizer when you would rather just roll over and get some shut eyes is so incredibly worth it! 

Step One:  A Few Quick Questions

The Visia™ Complexion Analysis machine works by first analyzing your skin and also by comparing your skin to others with your same age, gender and skin type so you know how you rank in comparison.  In order to compare “apples to apples” (so to speak) we have to input a few bits of demographic information so we can keep your records on file and so your results can be compared with those of your peers. We record your name, date of birth, skin type, the condition of the skin which in this case is whether or not you are wearing makeup.

Step Two: Getting into Position

Your aesthetician will instruct you to rest your chin and forehead in the proper position to be analyzed.  At Oculus Skin Care Centre we scan the left side of the face because it tends to get more sun exposure and consequently more sun damage as a result of driving.  At this point you will be instructed to close your eyes and remain very still so that the machine can snap two photographs of your skin.  

 
 
Step Three:  Selecting the area to be analyzed

The Visia™ Complexion Analysis Machine will take two pictures of the entire left side of your face however the entire area will not be used in your analysis.  The aesthetician will select an area to be used which includes the nose, cheek, under eye and the lower temple area by using a series of 11 points that will later be connected to form the testing area.

 
Step Four: The Results 

This is the moment you have been waiting for!  The report will populate based on your photographs and your digital analysis will be ready to view and interpret.  You will be scored in six different areas which include spots, wrinkles, texture, pores, UV spots and Porphyrins (bacteria).  Your score is how you rank in comparison to other people your same age, gender and skin type.  The scores are 1-100%; 50% being average for people your same age, gender and skin type, anything above 50% is better than average and anything less that 50% would be below average and shows some areas where you have some room for improvement.  The great thing about this is that you are being compared to a slew of others in the company of the Visia™ Complexion Analysis machine and your aesthetician.  Let’s face it; your aesthetician pretty well knows your skin’s challenges after a short conversation and a glance under their magnifier anyway so what a great person to have by your side during this moment of truth. You get to see how you rank in comparison with your peers without having to do the leg work and record keeping yourself. 

Step Five:  Devise a Skincare Plan of Attack

After your aesthetician has reviewed your results you may have questions.  This is a great time to discuss what seems to be working, what products need to be thrown away and what services and products can be implemented to take your skin to new places and keep it there.  There is one common tip given to everyone who gets a Visia™ Complexion Analysis and that is simply to wear sunscreen daily.  The very moment that you set your eyes on all of your past damage that is gunning its way to the top level of your skin will make you want to cover every inch of your body with sunscreen to prevent any more damage from occurring.  If seeing is believing than the Visia™ will make you believe in great skin care.  If you want to keep doing what you are doing there is actually a way to see how you will look in five years if you continue with your current skincare.  If you are ready to make a change this is a great place to start.  You will leave armed with some suggestions on how to help your skin and improve it overall and especially in the areas where you need some extra help.  You can re-do your Visia™ Complexion Analysis in six months or a year to see how the changes to your skin care routine are effecting your scores. This is a great way to gauge your process and to see what’s working for you.  You can be using “all the right things” and still not be addressing your skin in the best way.  For instance, you may be using a basic medical grade “cleanse, tone, treat and moisturize” skin care system morning and night and wearing an SPF for extra credit during the day and feeling pretty good about it.  You should feel great about it!  However, you are probably not using anything that will improve the texture of your skin.  If this is an area where you received lower than average scores you are missing your target and may need to add a chemical peel or exfoliating product into your weekly skin care routine in order to achieve optimal results.

The bottom line is that you have to start somewhere when it comes to your skin and what is more motivating than forward momentum?  It’s like the height chart on the door frame of your parent’s house or keeping a journal; it makes you feel like you are going somewhere if you track where you have been.  So come in today and take a few minutes to take two snapshots of your skin as it is today and then make plan to take it to a new place with products and services tailored toward your specific concerns.  Talk about highly personalized skin care options!  This targets skin issues that have yet to surface so you can stop them dead in their tracks and get you on the road to looking as young as you feel!  Call Oculus Skin Care Centre to schedule your analysis today or we can coordinate it with your next appointment with me.  You may not be excited to get your scores but it’s exciting to know that there are a variety of ways to improve them!

Your First Consultation: Getting the Most Out Of Your Consult

November 1, 2011 in Blepharoplasty, Great Skin, Lip Augmentation, Non Surgical Options, Surgical Options, Tear Trough Augmentation, The Endoscopic Browlift, The Endoscopic Cheeklift, The Facelift | Tags: , , , , , , , , , , , , , , , , , , | Leave a comment

All doctors enter into medicine for their own reasons.  My mother was a nurse and I was always intrigued by medicine but more than that I always wanted to help people.  In my specialty I have the privilege of treating patients with ailments that are medically necessary to treat and also patients that opt to make changes cosmetically.  In both cases I get to help my patients feel better using my experience and education and that is extremely rewarding and very fulfilling.  It is really nice to go home each day feeling like I have truly made a difference in the way that someone feels about themselves, that I have improved the functionality of their body or resolved an ailment that has brought a patient chronic pain for many years. 

Patients occasionally tell me that they are nervous when they come to see me, that they have never been to a plastic surgeon before, and for some that  it has taken years for them to get through my doors because they have been so scared to call and make an appointment.  I thought it would be a good idea to go over some strategies to insure that you get the most out of your consultation with me.  Although I have been doing this for a long time and am very comfortable discussing surgery I realize that coming to my office and discussing surgery can be far outside of my patient’s comfort zone and can bring about some anxiety.  My ultimate goal is that you feel confident while you are here and I feel knowing what to expect while you are here will help you to get the most out of your visit and will help us spend our time together wisely.  I hope that for some this insider knowledge will provide the encouragement that is needed to make that first call to my office; taking the first step toward meeting your surgery goals.  After all, if you never make it into my practice I will never have the pleasure of meeting you and helping you reach your aesthetic goals.

I think one of the first misconceptions is that I am going to take one look at you and give you a head to toe checklist of things that I think that you need to change.  That is absolutely not the case.  When you call to make your appointment you probably have already been thinking about and looking at the things in the mirror that you feel could look a little better or different.  I will go ahead and assume that you have done a little bit of research on what can be done to resolve your concerns as well.  Research material is abundant and very easy to attain in this day and age and it can be confusing and sometimes limiting.  Let’s say for instance that you are displeased with hollowness of your under eye area and seeing more prominence in your nasolabial folds (the lines running from the nose to the corner of the mouth).  You may search for possible ways to resolve this and decide that dermal fillers are the best way to address your concerns and you could be right.  Dermal fillers may in fact be a perfect fix to your concerns but if you want a more permanent result or if your aging concerns are more advanced than what fillers can adequately address an endoscopinc cheeklift may be the best choice for you.  Some patients come in thinking, “I’m getting fillers and that’s all I need” and when we discuss a cheeklift they may be caught off guard.   I think the key thing to remember is that I will address your concerns but it may not be exactly what you had figured out for yourself.  If you are unhappy with hollowness under the eyes I will review the various treatment options that are available to help resolve that hollowness.  There are a variety of treatment options for every concern and it is my responsibility to tell you my best recommendation as well as some alternatives.  It is up to you to decide which method of treatment aligns best with your goals, budget, and down-time constraints. 

Another thing to consider is that one size doesn’t fit all when it comes to plastic surgery.  If your sister is coming in with you don’t assume that she is just as displeased with the family under eye bags as you are.  She may be really focused on the lines on her forehead that you have yet to fret over.  This is precisely why I address the unique concerns that each patient brings to my attention.  People get used to the way they look and some people have learned to embrace what others perceive as “imperfections” as their own unique features that make them who they are.  Think Cindy Crawford’s signature mole or the gap between Madonna’s front teeth.  Just as this is true you should also consider that your friends that are your same age, that you have everything in common with, who have kids the same age as you, and wear the same size clothes as you have completely different genetics and plastic surgery needs.  It can be fun and perhaps a little less nerve wracking to come to a plastic surgery consult with a friend but I would caution that it can be a little strange leaving when your friend happily gets 1cc of Botox® while you leave with a quote for a complete overhaul.  It may be fun to have a friend in tow for a quick Botox® visit but for a surgical consultation it would be best to come alone or to bring along a trusted loved one as another set of ears (people tend to be a little nervous and forget what we discuss), to keep you company and to support you at your consultation.  You can repay the favor for them another day.  It’s best if you focus on key reasons why you are there and that it doesn’t turn from a fun friend outing to a comparing of aesthetic “score cards”. 

Let’s get back to the research step for a moment.  Selecting the perfect board certified surgeon for you is the most important step that you can make on the road to the new you.   Surgery is something that should be taken very seriously and the research can be daunting but we help you along the way at Oculus.  In addition to any research that you do on your own my website has an abundance of information on the various procedures that I perform at my practice and in my fully accredited surgery center (Specialty Surgery Center, Inc.).  There will be a basic over view of each procedure, some additional information about the concerns that may be addressed by each procedure and some frequently asked questions including recovery times, limitations and anesthesia type. While you are visiting this blog you may notice that there are blogs on other topics that may be of interest to you as well.  It is  helpful and may even be comforting to read up on a few things that you may be interested in discussing with me while you are at your consultation.  Jot down a few questions or points to discuss with me and make certain to bring them with you when you come in for a visit.  While you are at your consultation we will discuss your concerns in detail and I will answer any questions that you may have.  We will take some pictures of you that will be enhanced after your visit and emailed to you so that you may have a better idea of what to expect after surgery.  You will meet with my Patient Coordinator Jennifer after your consultation who will go over your detailed quote for the procedures that we discussed during your visit.  She will also answer any questions that you may have about financing options and schedule availability.  She will touch base with you along the way to make sure that all of your questions are answered and when you are ready she will schedule your pre-op visit, surgery, post-op visits and help you fully prepare for your surgery.  Feel free to contact Jennifer (jenniferm@oculusplasticsurgery.com) directly if you have additional questions before you schedule your initial consultation.  She is more than happy to speak with you as needed and to schedule your consultation.

I hope I have helped to make you feel a little more comfortable as you plan for your consultation.  Be sure to write down your questions before you arrive, take notes while you are here and come prepared to hear all of the appropriate treatment options there are right for you.  The most important thing is to feel good about the process and to feel good about your self.  Remember that plastic surgery will do nothing to change who you are on the inside.   Anything that we do at Oculus from facials to surgery aims to make you look like a younger version of yourself.  I look forward to helping you start your journey back in time.

The Endoscopic Browlift: Smoothing Foreheads and Raising Brows

October 6, 2011 in Surgical Options, The Endoscopic Browlift | Tags: , , , , , , , , , , , , , , | Leave a comment

It’s not news that as we age everything on our body tends to wander due to gravity.  If this is news, now you know and you have something to look forward to as you get older.  The eyes are the first place on the face to begin to show signs of aging.  Crow’s feet form around the eyes due to repetitive expressions and small lines begin to stretch across the forehead in a patient’s mid to late 20′s and sometimes even earlier depending on  the patient’s genetics and skin care discipline.  In a patients 30′s the eyebrows can migrate closer to the eyelashes decreasing the amount of the eyelid that is visible.  Starting in a patient’s 30′s and going forward the skin loses its elasticity and the excess skin on the eyelids coupled with shifting fatty deposits in the face can cause the eyelids to droop and become troublesome.  In some more severe cases the eyelid can be so heavy and loose that it can actually impair the patient’s vision.  So many patients come to me as an Oculofacial Plastic Surgeon to discuss their eyelids and are thrown when I mention an endoscopic browlift.  When they look in the mirror their eyelids are the problem and fixing them is the solution.  Sometimes this is the case while for other patients the lids are only part of the problem and an extra step must be taken in stabilizing the brow.  The endoscopic browlift is a highly specialized surgery designed to do just that.

The main goal of the browlift is to stabilize the brow.  This means positioning the brow back into its natural and youthful position which is on the brow bone.  This prevents further descent of the brows over time which in some patients is inevitable especially when I surgically address the excess skin or drooping on the eyelid.   The added pressure from the brow can create heaviness and skin redundancy on the eyelid and also cause an angry or cold expression on a patients face.   The browlift stabilizes the space between a patient’s eyebrow and eyelashes.   Another benefit of the brow lift is the smoothing of the patient’s forehead.  Some patients find that after a browlift they no longer need to get Botox® treatments in their forehead.  Most patients have some degree of asymmetry in their brows naturally which can be improved during the surgery as well.  The endoscopic browlift can be done alone while in most cases it is combined with other surgeries in order to maximize results as it is with my Eyelight™ Blepharoplasty.

During an endoscopic browlift four small access sites are made just inside the hair line above the forehead.  The incisions are about a half inch in size and heal even smaller causing minimal scarring that is concealed by the natural hairline.  Using the endoscope a small fiber optic lens, externally attached to a camera and monitor, is inserted and helps with visibility.  Other small tools are guided through and I am able to work externally with the help of the camera to perform the browlift. 

The procedure is performed in the operating room and takes approximately 30 minutes to complete.  Patients are educated about downtime, healing, discomfort and the benefits of every surgery that I perform.  The endoscopic browlift is minimally invasive and with such small incisions the patient enjoys very little scarring and downtime.  Within the first week a patients swelling and bruising will be resolved by 85% and will continue to heal over the next couple of weeks.  Patient discomfort ranges from virtually no pain to tenderness to mild pain around the incision and the forehead.  Most patients find their pain levels to be tolerable and some opt not to take the prescribed pain medication because they feel fine and would like to get back to driving and other daily activities that can be restricted while taking pain medication.  The benefits of the endoscopic browlift is minimal scarring, less bleeding, virtually no hair loss, and very little instance of numbness in comparison to the open techniques where the patient’s incision extends from ear to ear through the hairline.  Two weeks after an endoscopic browlift, patients are released to their full activity level.  Most patients return to work in days to one week after surgery.

This is an actual patient's before and after surgery picture. This patient had an endoscopic browlift, upper eyelid ptosis repair, and laser skin resurfacing of the eye area. Notice the increase in the space between her eyebrows and eyelashes and the softening of her expression. Before Surgery (Upper) After Surgery (Lower)

Many patients want to know if they are going to look “surprised” or have a dramatic and unnatural brow.  The benefit of making four small incisions allows me to adjust the brow medially and laterally which keeps the brow looking natural by aligning its new position with your natural eyebrow contour.  Some surgeons offer fewer incision sites which may seem appealing but can often leave patients with a harsh and abrupt arch to their brow which can look unnatural and overdone. 

As with any surgical procedure it is important to select a surgeon that is specialized in the type of surgery in which you are interested.  As an Oculofacial Plastic Surgeon I feel the endoscopic browlift is a wonderful procedure that offers exceptional results with minimal downtime and may be used to accentuate and extend the results of eyelid surgeries such as blepharoplasty and ptosis repair and other cosmetic surgeries.  An endoscopic browlift gives my patients a natural and rested appearance in the space between the brows and eyelashes; softening harsh expressions, and reframing the face in a pleasing and youthful way.

The Endoscopic Cheeklift: A Great Solution to the Aging Concerns of the Midface

September 16, 2011 in Surgical Options, The Endoscopic Cheeklift | Tags: , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Many of my patients come in with concerns of sagging and descent of the cheek or midface.  They may not realize that their concerns are due to mid face descent but most patients in their mid to late thirties complain about similar things.  They know that they are not a candidate for a full traditional facelift though they have concerns and want to look better than they do and possibly put off a larger surgery for several years.  They are starting to notice hollowness, deepness and darkness under the eyes, more pronounced lines beside the mouth, and loss of volume in the cheeks and face.  While some patients may start to see some extra skin in the neck and lower face for a majority of patients the area of concerns is around the midface or cheek area. 

As we age the cheek tissue begins to descend from the cheek bone and move slowly down the face.  This shift in fat and tissue, although small, creates noticeable changes in the areas surrounding the cheeks.  The area just below the eyes that used to transition smoothly to the fullest part of the cheek in your youth is now divided by a deep and dark rut.  The cheek tissue removes volume from the under eye area as it descends which presents itself as a tired and dark appearance that is almost impossible to cover with a concealer.  The nasolabial folds, running from the corner of the bottom of the nose to the mouth, are affected as well because the tissue that is slowly shifting downward on the face is putting increased pressure on the folds causing them to be more pronounced.  With the cheeks shifting downward it can cause a face that was once full and youthful to appear gaunt or sunken.  The cheeks themselves are a symbol of youth.  When you see a child, or a young super model you see fuller, round and shapely cheeks which balance the face and accentuates other key features including the eyes and lips.  Although the aging process is a very slow one some patients seem to feel that these noticeable changes happen over night.  The subtle changes brought about by the shifting of the cheek alone effect the symmetry of the face in such a noticeable way because it manages to alter every key part of a patient’s face.

In some cases dermal fillers may be used to increase volume in targeted areas of the face.  Fillers can be especially effective in the tear troughs to help combat the hollowness caused by aging.  Stimulatory fillers such as Sculptra® may be used to combat facial volume loss with a series of treatments over time for patients that may prefer a more subtle treatment with longer lasting results. Other fillers can be used to bring fullness to the cheeks or to help fill the nasolabial folds.  If volume loss is the primary concern the use of fillers alone may provide a pleasing overall result.  Keep in mid that the use of fillers is merely a form of camoflague and provides a temporary fix until a patient is ready for surgery which will repair the problem area and is long lasting.

For patients where facial volume has shifted in a displeasing way or for those who want a more permanent fix, an endoscopic cheeklift is the best option.  During the first part of an endoscopic cheeklift, I reposition the fat and tissue of the cheek back onto the cheek bone where it once was.  I use a product called Endotine™, which is made of a material similar to dissolvable sutures, to hold the cheek in the proper position while it heals. The Endotine™ will dissolve over several months leaving the cheek secured in it’s new position. By restoring the cheek to its original location the patient enjoys increased volume under the eyes, less pressure on the nasolabial folds and a youthful appearance to their cheeks from which they have benefited from during their younger years.  The second part of the procedure involves the under eye area.  Depending on the patient I may use one of two techniques to renew and tighten the skin under the eye.  For some patients laser skin resurfacing is utilized to renew the skin while for others a lower Blepharoplasty may be performed to remove  fat from the lower eye area leaving the skin smooth and firm. Addressing the lower eyelid is necessary as it ensures that the patient has a flawless transition from the lower eye to the cheek and the skin is reconditioned to perform how it once did naturally.  It’s not about adding volume (in most cases); it’s about repositioning the existing volume in a more pleasing way.

Actual patient before (left) and after surgery (right)

It is important to know that this is NOT a “mini” lift that can be done under local anesthesia during a lunch hour. These “quick-fix” surgeries are designed to require a shorter recovery time and smaller investment but with that will yield a lesser and more temporary result. The endoscopic cheeklift surgery that I perform takes a little over an hour and is performed in the operating room which makes the procedure comfortable and keeps the patients still as I work.  The incisions are very small and completely concealed which means no visable scarring on the face.  Dissolvable sutures are used during this procedure and do not require removal. One week after surgery most patients return to their normal activities.  A small amount of swelling may remain even after the first week but will resolve over time leaving the patient with lasting and beautiful results.

If you are noticing that your eyes look more hollow, your cheeks are not as round and pleasing as they once were or that your nasolabial folds are becoming more pronounced and this is concerning to you; it may be a good time to schedule a consultation with me.  During your consultation we will discuss your concerns and figure out the best way to go about addressing them.  It is sometimes helpful to write down any questions that you may have prior to coming to your consultation to make sure that we cover all of your concerns.  If you decide that you would like to pursue treatment using dermal filler I will likely be able to administer the fillers the same day.  If surgery is a better choice, we will take some photographs which will be digitally enhanced so that you may better visualize your surgical results.  This is a great way to get a feel for what to expect if you choose to have surgery and to also be sure that you and I are on the same page in respect to your surgical goals. 

The endoscopic cheeklift is one of the most popular surgeries that I perform in my practice.  Patients are starting earlier with surgery knowing that using fillers and having some smaller procedures now, can put off a dramatic overhaul in their fifties and sixties.  The endoscopic cheeklift is ideal for the patient that is noticing significant signs of aging in the midface but does not yet have major concerns in the lower face and neck area.  It utilizes advanced techniques that provide a very natural and youthful result with minimal downtime and lasting results.  I look forward to seeing you at your consultation and helping you look as amazing as you feel!

Computer Imaging: Envision the Possibilities of Surgery

August 23, 2011 in Non Surgical Options, Surgical Options | Tags: , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

Now you see it, now you don’t.  Patients want instant results.  They want to know what to expect from surgery, recovery and when they will be fully back to feeling like themselves. I offer Computer Imaging which is an extremely helpful and educational tool for my patients.  This tool allows patients to see where they are headed physically and also ensures that we are on the same page in respect to their surgical  goals.

When a patient comes to me for a consultation, there may be one specific thing that they are coming to discuss and other things that they hold deeper that may be delicately lobbed into our conversation.  We may stick to the subject at hand and branch off into these additional topics during a primary consultation.  In some cases a patient may keep their deeper concerns under wraps for a long time until they feel safe and comfortable enough to discuss with me that they are  unhappy with their neck, lower face, sunken eyes, or acne scarring and have been for several years.  My patients come to me with deeply personal concerns and often things that have caused them to feel self-conscious or even embarrassed.  I am sensitive to that and try to work at the patient’s pace to address their concerns in a consultation.  I have learned that people do not bring up things unless they want to discuss them and I work with that in mind as I discuss a patient’s concerns and how I can address them; surgically and non-surgically. After a consultation most patients  feel an emotional high because they are excited about the coming enhancements to their appearance.  Other patients feel a bit depleted after sharing something so personal and often rooted to bad feelings about themselves.  Both feelings are normal.  Myself, along with my staff will be there to answer questions and to help you as you make your decision about surgery. 

Computer Imaging is one tool that really helps patients envision their results and feel more content about their choice to make enhancements to their appearance.  During a consultation we take pictures that are then digitally enhanced to show a patient their prospective results from surgery.  We have patients that keep this picture on their bathroom mirror in anticipation of their surgery day.  One patient even told me that she placed it on her refrigerator and it served as a great motivation to help her lose weight before her surgery; a personal goal of hers. 

As is to be expected, patients can be frightened to make changes to their appearance; especially so when it comes to their face and eyes.  Computer Imaging is a great way to get an idea of what you can look forward to.  Some patients have an “idea” of what cosmetic surgery is and is not and these ideas are frequently misunderstood.  Giving a patient a digitally enhanced picture of themselves allows them to get a better idea of what to expect after they have surgery with me; it’s personal.  Every patient is unique and every surgeon has a surgical style all his own.  It is important that your goals align well with my style.  With that said,  my style is natural and meant to enhance and complement your features, not to recreate you all together or to make you look unlike yourself.  When considering something as personal as facial cosmetic surgery it is imperative that you be on the same page as your surgeon so you get pleasing results and address your concerns fully.

Left: Patient Before Right: Patient's Computer Imaging

Computer Imaging is included as a part of our consultation and is complimentary.  Discussion allows me to find out more about you, what brings you in to see me, and for me to review the procedures with you to find the perfect fit.  After you have the necessary information about the specifics of the procedures the decision to have surgery becomes a highly personal one.  Having a picture of themselves with their desired results has been extremely helpful for my patients as they have made the decision to have surgery with me.  Most say that they look even better than the computer image they received!

 

Left: Patient Before Right: Patient’s Actual Post-Surgical Results

Computer Imaging is a very popular service that we offer in my practice.  Patients really look forward to seeing their pictures and for most patients computer imaging is an integral step in the decision making process.   This amazing tool really helps patients to visualize the new them and get excited about a change that is so personal and often emotionally rooted.  Call today to reserve a consultation and you can see your beautiful digital results in about a week’s time.  I only wish surgery and recovery was as speedy as a few clicks of the mouse!  I look forward to meeting you soon!

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