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Who Should Consider A Forehead Lift?
With time most eyebrows fall, crowding the upper eyelids. The forehead can also develop deep furrows. Between the eyebrows, frown lines can impart an angry, tired or worried appearance.
These changes are the result of aging and the action of muscles beneath the skin. With time, the muscles that hold the eyebrow in proper position relax allowing the eyebrow to move downward. Although this occurs most commonly along the outer portion of the brow a droop of the inner brow can also be seen. When the brows are low there is a natural tendency to use the forehead muscles to hold the eyebrow upward. This causes the gradual formation of deep furrows across the forehead. Frowning causes lines that gradually form between the eyebrows and in some people become quite noticeable.
Endoscopic forehead surgery can help turn back the effects of time and muscle action on the forehead. It can even rejuvenate your self confidence, giving you the freedom to boldly enjoy life.
Most forehead lift patients are between thirty and sixty years old; however, very successful surgery can also be performed on patients that are younger or older.
The endoscopic forehead lift is used to elevate the eyebrows, smooth the forehead and decrease the effect of muscle contraction on the area between the eyebrows. It can be combined with other facial plastic surgery operations such as eyelid surgery, facelift surgery and laser skin resurfacing.
Planning Surgery
Each patient has very individual and specific concerns. During your consultation these concerns will be discussed. An evaluation of your face, neck and forehead will be made in order to determine if forehead lift surgery is appropriate. Photographs will be taken as a part of your permanent record. These help to plan the surgery and to evaluate the post-operative result. A medical history will be obtained that includes general medical problems as well as smoking, the use of medications that can promote bleeding and any healing difficulties that you may have.
Having realistic expectations about the results of surgery is very important. These should be discussed during the consultation. Your overall emotional state is also important as it can effect both your satisfaction with surgery and your post-operative course.
Before Surgery
It is important to follow any instructions given to you prior to surgery. These will include information on eating, smoking and medication usage. It is very important to stop smoking prior to surgery. Smoking causes decreased blood flow to the skin and can impair healing. Carefully following your instructions will make the surgery and post-operative recovery easier.
The Endoscopic Forehead Lift Procedure
The goal of the endoscopic forehead lift procedure is to elevate the eyebrows, smooth the forehead and remove frown lines between the eyebrows.
Several small incisions are made in the hairline. An endoscope is then employed to see below the scalp. The forehead is freed and the eyebrows elevated. This also smoothes the forehead. When appropriate, muscles between the eyebrows are removed to decrease frown lines in this area. Several surgical staples are used to close the incisions. Even though small incisions are utilized it is possible to constantly visualize the progress of surgery through the endoscope. The entire procedure takes between one and two hours. A small dressing is often applied.
Anesthesia
At the beginning of surgery medications are given to relieve anxiety and pain. A general or local anesthesia is employed to maximize your comfort.
Post-operative Effects
Some bruising and swelling are normal after surgery. These can last several weeks and subside gradually. Mild pain, easily controlled with medication, is common for several days after surgery. Significant pain is very rare and should be brought to our attention. Bandages when employed are removed within several days. Staples are removed in about one week.
Complications
The risks of endoscopic forehead lift surgery are infrequent and typically minor. There is however a great variability in an individuals healing ability, underlying anatomy and reaction to surgery. The results of surgery are therefore never completely predictable.
The most common complications of surgery include a collection of blood under the skin and temporary numbness in the forehead area. Suspected problems should be brought to our attention promptly. To minimize the likelihood of complications be certain to carefully follow your pre-operative instructions.
The Cost
The costs of cosmetic surgery vary depending on the complexity and length of the surgery required as well as the facility where the surgery is performed. There is both a surgical and a facility fee. Anesthesia and facility fees are incurred when general anesthesia is necessary. Your fees will be fully discussed with you after your initial consultation. Payment of fees for cosmetic surgery is expected prior to surgery since these types of surgery are not covered by insurance.
Who Should Consider Cosmetic Eyelid Surgery?
With time the skin of the upper eyelid stretches and hangs downward covering more and more of the upper eyelid. Eventually the eyelashes disappear under the drooping skin. A bulge of fatty tissue can also appear in the inner portion of the eyelid. In the lower eyelids prominent bags of fatty tissue are seen as well as some degree of wrinkly skin.
These changes are the result of aging and the action of muscles beneath the skin. There are elastic fibers in the skin. These fibers eventually lose their snap back ability allowing the skin to become wrinkly and to hang downward. Additionally, there is what can be thought of as a door in both the upper and lower eyelid. This door holds the normal fatty tissue back so it is not seen. Eventually, this door weakens allowing the fatty tissue to move forward. This is seen as a bulge or "bag" in the eyelids.
Cosmetic eyelid surgery can help turn back the effects of time and muscle action on the eyelids. It can even make you feel better about yourself. It can not, however, make you younger or completely change your appearance.
Most cosmetic eyelid surgery patients are between thirty and sixty years old. Very successful surgery can also be performed on patients that are younger or older.
The cosmetic eyelid surgery is used to tighten the eyelid skin and to remove the bags caused by bulging fat deposits. It can be combined with other facial plastic surgery operations such as endoscopic forehead elevation, facelift surgery and laser skin resurfacing.
Planning Surgery
Each patient has very individual and specific concerns. During your consultation these concerns will be discussed. A complete evaluation of your eyelids and the area around them will be made in order to determine if cosmetic eyelid surgery is appropriate. Photographs will be taken as a part of your permanent record. These help to plan the surgery and to evaluate the post-operative result. A medical history will be obtained that includes general medical problems as well as smoking, the use of medications that can promote bleeding and any healing difficulties that you may have.
Having realistic expectations about the results of surgery is very important. These should be discussed during the consultation. Your overall emotional state is also important as it can effect both your satisfaction with surgery and your post-operative course.
Before Surgery
It is important to follow any instructions given to you prior to surgery. These will include information on eating, smoking and medication usage. It is advisable to stop smoking prior to surgery. Smoking causes decreased blood flow to the skin and can impair healing. Carefully following your instructions will make the surgery and post-operative recovery easier.
The Cosmetic Eyelid Surgery Procedure
The goal of cosmetic eyelid surgery is to tighten and smooth the skin of the eyelid. In the upper eyelid this should pull the skin upward, away from the eyelashes thereby allowing more of the upper eyelid to be seen. Fatty tissue is typically removed as well.
The incision for upper eyelid surgery is hidden in the natural crease of the eyelid. A measured amount of skin is removed. Care is taken to be certain that enough skin remains to allow the eyelids to close properly. Any fatty tissue is now removed. A concealed suture closes the skin.
Lower eyelid surgery can be performed in several ways. When appropriate, an incision can be made on the inside of the eyelid completely hiding the surgery. At other times a skin incision is camouflaged by placing it just beneath the eyelashes. Through either incision the fatty tissue is removed from the lower eyelid helping to flatten it. At times, the skin is further tightened and smoothed by skin removal or the application of a skin resurfacing laser. When sutures are utilized these will dissolve on their own.
The entire procedure takes between one and two hours. At the end of surgery ice is applied to the area to reduce swelling and black and blue. No bandages are used allowing you to see immediately after surgery.
Anesthesia
At the beginning of surgery, medications are given to relieve anxiety and pain. A local anesthetic is administered to the operative area. You will typically be sleepy enough not to perceive what is going on. Keeping you comfortable is very important.
Post-operative Effects
Some bruising and swelling are normal after surgery. These can last several weeks and subside gradually. Mild pain, easily controlled with medication, is common for several days after surgery. Significant pain is very rare and should be brought to our attention. Ice is applied intermittently for 48 hours after surgery while awake.
Complications
The risks of cosmetic eyelid surgery are infrequent and typically minor. There is however a great variability in an individuals healing ability, underlying anatomy and reaction to surgery. The results of surgery are therefore never completely predictable.
The rare complications of surgery include bleeding, infection and retraction of the eyelid. Suspected problems should be brought to our attention promptly. To minimize the likelihood of complications be certain to carefully follow your pre-operative instructions.
The Cost
The costs of cosmetic surgery vary depending on the complexity and length of the surgery required as well as the facility where the surgery is performed. There is both a surgical and a facility fee. Your fees will be fully discussed with you after your initial consultation. Payment of fees for cosmetic surgery is expected prior to surgery since these types of surgery are not covered by insurance.
Who Should Consider Laser Skin Resurfacing?
With time most people's skin will form deep or superficial wrinkles. The skin under the eyelids can become loose and crinkled. Additionally, it can take on a weather beaten appearance. These changes are due to the constant action of muscles on the overlying skin. This can all be attributed to aging.
The wrinkle lines are commonly seen under the eyes and along the outer portion of the eyes where they are known as "crow's feet". They are frequently seen as vertical lines on the upper lip typically in smokers. To varying degrees, they also occur on the forehead, cheeks and lower portion of the mouth.
Cosmetic laser skin resurfacing can help turn back the effects of time and muscle action on the face. It can even make you feel better about yourself. It can not, however, make you younger or completely change your appearance.
Most skin resurfacing patients are between thirty and sixty years old. Very successful surgery can also be performed on patients that are younger or older.
Cosmetic laser skin resurfacing is used to smooth wrinkles of the face and to rejuvenate the texture of the skin. It can be combined with other facial plastic surgery operations such as eyelid surgery, facelift surgery and endoscopic forehead lift surgery.
Planning Surgery
Each patient has very individual and specific concerns. During your consultation these concerns will be discussed. An evaluation of your face, neck and forehead will be made in order to determine if cosmetic laser skin resurfacing is appropriate for you. Photographs will be taken as a part of our permanent record. These help to plan the surgery and to evaluate the post-operative result. A medical history will be obtained that includes general medical problems as well as smoking, the use of medications that can promote abnormal recovery and any healing difficulties that you may have.Having realistic expectations about the results of surgery is very important. These should be discussed during the consultation. Your overall emotional state is also important as it can effect both your satisfaction with surgery and your post-operative course.
Before Surgery
It is important to follow any instructions given to you prior to surgery. These will include information eating, smoking and medication usage. In general, your skin should not be tanned prior to laser skin resurfacing. An anti-viral medication will usually be prescribed prior to treatment. Carefully following your instructions will make the treatment and post-operative period easier.
Post-operative Effects
After surgery the treated area will be red and tend to weep for several days. Redness persists for a longer period of time. The exact length of time depends on the area treated and the type of laser used. Mild discomfort, easily controlled with medication, is common for several days after treatment. Significant pain is very rare and should be brought to our attention.
Complications
The risks of laser skin resurfacing are infrequent and the side effects are typically minor. There is however great variability in an individual's healing ability, underlying anatomy and reaction to treatment. The results of treatment are therefore never completely predictable.
The most common complications of surgery include prolonged redness and superficial infections. suspected problems should be brought to our attention promptly. To minimize the likelihood of complications be certain to carefully follow your pre-operative instructions.
The Cost
The costs of cosmetic surgery vary depending on the complexity and length of the treatment required as well as the facility where the treatment is performed. Anesthesia and facility fees are incurred when general anesthesia is necessary. Your fees will be fully discussed with you after your initial consultation. Payment of fees for cosmetic surgery is expected prior to surgery since these types of surgery are not covered by insurance.
What is Alloderm?
Alloderm is an acellular dermal graft from donor tissue. The patient's body incorporates this material producing an essentially permanent enhancement. Other material such as collagen only produces a temporary enhancement. The body will not reject Alloderm since it is biologically inert. It has been used for many cosmetic procedures including lip rejuvenation procedures.
Who Should Consider Alloderm?
Patients who are concerned about the thinness of their lips, who want fuller more voluptuous lips will benefit from this procedure. It is also used effectively in patients who have sustained trauma and need reconstruction of their lips.
Before Surgery
Measurements are taken of the lips to determine the amount of fullness to be achieved. Expectations are discussed in detail between the physician and patient. Since the material is permanent, it is better to do less than more. Each procedure is individually tailored to the patient's needs.
Alloderm Procedure
Tiny incisions are made at both corners of the lip. An elevator instrument is passed from one incision to the other to make a tunnel for the alloderm material. The alloderm is sized according to the patient's preoperative evaluation. It is then passed from one end of the incision towards the other end. The corners of the lip are then sutured with absorbable suture material that will dissolve in 1-2 weeks.
Anesthesia
The procedure is done under local anesthesia with sedation. The patient is comfortable and does not experience pain.
Post-operative Effects
The postoperative effects are dramatic. Depending on what the patient desires, the fullness can be achieved at the corners, in the middle or along the length of the lip. Both upper and lower lips can be done at the same time. You will not be able to whistle for approximately 3-6 months. There will be some swelling during the first week before the alloderm starts to shrink to an appropriate size. When kissing, the sensation will be minimal for the first few months. The lips will feel hard initially but soften over time. The total healing process takes 6 -12 months. Smokers will heal much slower than nonsmokers.
Complications
The major complication is over correction. The risk of this is minimized by the physician fully understanding the patient's expectations. Infection is rare and is minimized by using antibiotics postoperatively. As with any surgery there is always the risk of needing further surgery. The amount of scarring is minimal because the incisions are carefully placed at the corners of the lip.
The Cost
Insurance companies do not cover this procedure. The price, which includes surgical fees as well as the facility and anesthesia fees, is discussed with the patient preoperatively.
Frown Lines
When we frown for any reason, we gather the tissue between our eyebrows into a fold. In some of us, this causes a chronic furrow. This produces a frustrated, discouraged, angry look on our face. This can be distraction to others, and a bother to ourselves.
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What is BOTOX®? BOTOX® is the trade name of Botulinum Toxin Type A, a purified substance produced by the bacterium Clostridium botulinum. In large amounts, this substance blocks the nerve impulses to muscles, causing a form of paralysis called botulism. By using extremely small doses of BOTOX®, injected directly into a specific muscle, only the action of that muscle will be paralyzed. Therefore, the problem that muscle causes, like a twitch, spasm or frown line will be stopped.
Where is BOTOX® Placed? The frown lines between the eyebrows are caused by the action of a muscle called the corrugator. You can feel this as a thickening just below the inside of your eyebrows, when you purposefully make yourself frown. Injection BOTOX® directly into the corrugator muscle stops your ability to draw your eyebrows together when you frown. Once the muscle is paralyzed, it cannot contract, and the fown line gradually fade away.
Will It Last? The actual treatment takes only a few minutes and the BOTOX® takes effect in three to four days. Gradually, over three to five months, the BOTOX® will fade and the muscle action will return. When the frown line starts to reappear, a simple repeat treatment is all that is necessary to maintain the desired result. |
Can BOTOX® Be Used For Other Wrinkles?
BOTOX® is also effective in the treatment of crow's feet and forehead wrinkles. Additionally, it is useful in treating wrinkles around the mouth and neck folds.
Who Can Perform BOTOX® Treatments?
This therapy should be done only by a physician trained in the use of BOTOX®.
How Has BOTOX® Been Tested?
BOTOX® has been used since 1980 for the treatment of strabismus (lazy eye), blepharospasm (uncontrolled eye blinking), and facial spasm. BOTOX® was first used for cosmetic conditions such as forehead wrinkles in 1989.
Side Effects
The side effects of BOTOX® are related to the local injection of the solution. There will be a slight discomfort from the needle entering the skin, and a small chance of a bruise at the site of the injection. There are no reports of damage to the eye. There have bee no permanent side effects from the use of BOTOX®. Approximately 1% of patients will develop a slight lowering of ptosis of one eyelid. This is temporary, and may not even be noticeable.
Role of Your Ophthalmic and Facial Plastic Surgeon
Certainly, the physician most qualified to work around your eyes is your ophthalmic and facial plastic surgeon whom you have known and trusted to do other surgeries and procedures. We are completely familiar with the delicate tissue and anatomy surrounding the eyes and face. We will be more than happy to answer any of your questions about your special needs, and about this remarkable procedure.
What is RADIESSE-
Radiesse® dermal filler is made of calcium-based microspheres suspended in a water-based gel, and is injected into the skin through a simple and minimally invasive procedure. RADIESSE dermal filler is the ideal choice for total facial contouring. It can restore a healthy, youthful appearance, enhance your existing features, help you defy age and gravity, and increase your confidence – all without invasive surgery or scarring.
RADIESSE dermal filler is ...
Naturally superior
RADIESSE dermal filler works with your own body in a remarkable way. Upon injection, it immediately adds volume to safely contour, correct, and beautify facial features. And unlike other fillers, RADIESSE dermal filler continues to work over time. With its patented microsphere technology, it starts a process called collagenesis, stimulating your body to produce new collagen and encouraging collagen to grow around the injection area. RADIESSE dermal filler actually helps your body create its own naturally younger look, setting a new standard in facial contouring and augmentation.
Safe
RADIESSE dermal filler has been clinically tested extensively for years, with excellent safety and efficacy results. It has received CE mark certification, two FDA approvals, and a number of FDA clearances. RADIESSE dermal filler is made from a biocompatible substance that’s identical to what’s naturally found in the body. There’s virtually no risk of allergic reaction, and there have been very few side effects reported in clinical trials and actual use.
Immediate and long-lasting
Treatment with RADIESSE dermal filler is so simple and convenient, it can be performed during a lunch hour. You’ll see the results right away - and these results may last up to a year or more for many patients. The long-lasting effects of RADIESSE dermal filler can reduce the need for retreatment, which saves you time and money compared with other fillers.
How it works
Radiesse® dermal filler is made of unique, patented, calcium hydroxylapatite (CaHA) microspheres suspended in a water-based gel carrier. When injected into the skin, these microspheres initially perform as a filler - they immediately provide facial volume for a soft, natural look. The transformation is noticeable right away. Over time, your body will gradually absorb the gel carrier, but the very tiny, smooth microspheres remain.
Upon injection, RADIESSE dermal filler immediately adds volume to facial features.
Macrophages continue to dissolve the gel carrier. Fibroblasts form new collagen.
New resident tissue (collagen) surrounds the CaHA microspheres.
The CaHA microspheres degrade and are phagocytized and metabolized by macrophages.
Even the small fragments of CaHA are decomposed at the implant site, without evidence of migration.
What to Expect — Set your sights on growth
Great eyelashes don't just happen overnight. That's why it's important to note that LATISSE™ (bimatoprost ophthalmic solution) 0.03% works gradually and remarkably — starting at 4 weeks with full results after 16 weeks. Once you begin treatment, you could start to see results in as little as 4 weeks, but you must continue applying the topical treatment each night and follow the directions for best results. Remember results are gradual over time.
Your eyelashes will experience real measurable growth.
LATISSE™ works from the inside out. As the treatment progresses, you'll begin to see changes in length, thickness and darkness gradually. After week 16, you'll see the full effect of LATISSE™ — and so will others.
There are possible side effects.
Throughout clinical trials, some users did experience itchy eyes and eye redness. However, some users found that these irritations went away once they became accustomed to the product or began applying it properly. As with any prescription treatment, always consult with your doctor for information and proper usage of LATISSE™ solution.
Timeline
In the clinical study, 78% had a significant increase in overall eyelash prominence (including elements of length, fullness, and darkness) at week 16.
What Is JUVÉDERM® Injectable Gel?
As we age, our skin changes. Over time, the natural volume of youthful skin begins to diminish as wrinkles and folds form. But, with JUVÉDERM® injectable gel, you don't have to just sit back and let it happen!
JUVÉDERM® is the ONLY hyaluronic acid (HA) filler FDA approved* to last up to 1 year
JUVÉDERM® is a smooth consistency gel made of hyaluronic acid—a naturally occurring substance in your skin that helps to add volume and hydration. Your healthcare professional eases JUVÉDERM® injectable gel under the skin to instantly restore your skin's volume and smooth away facial wrinkles and folds, like your “smile lines” or “parentheses” (nasolabial folds—the creases that run from the bottom of your nose to the corners of your mouth).
JUVÉDERM® provides a smooth, natural look and feel—so everyone will notice (but no one will know)! In fact, studies show superior results of JUVÉDERM® compared to a collagen-based dermal filler.
Benefits of JUVÉDERM® Injectable Gel
Hyaluronic acid dermal fillers like JUVÉDERM® injectable gel offer a safe and effective nonsurgical option for smoothing facial wrinkles and folds. In fact, they are the fastest growing nonsurgical aesthetic procedure in the United States, according to the American Society of Aesthetic Plastic Surgery. (1) But all dermal fillers are not the same!
Choosing JUVÉDERM® injectable gel makes a difference:
* JUVÉDERM® is the ONLY hyaluronic acid (HA) filler FDA approved* to last up to 1 year. Our unique manufacturing process provides a high concentration of cross-linked hyaluronic acid for long-lasting results. It also creates a smooth consistency gel that flows easily into the skin and provides a smooth, natural look and feel—so everyone willl notice (but no one will know)! Only JUVÉDERM® is so smooth—other hyaluronic acid fillers currently on the market are made of granular consistency gels.**
* A "next-generation" filler: JUVÉDERM® is a “next-generation” non-animal dermal filler that is made from hyaluronic acid—a naturally occurring substance that plays a vital role in hydrating your skin and replenishing its natural volume. No allergy skin tests are needed prior to receiving treatment.
**Dry test, extrusion of a small amount (≈.025 mL) of JUVÉDERM® and RESTYLANE onto a glass surface at 9x magnification.
†RESTYLANE is a registered trademark of Q-Med AB.
* Proven safety and effectiveness: JUVÉDERM® injectable gel is the first FDA-approved hyaluronic acid dermal filler proven safe and effective in persons of color.
* Quick and easy procedure: JUVÉDERM® injectable gel is a nonsurgical physician-administered treatment that requires no allergy skin test and minimal recovery or downtime.
* Personalized treatment: JUVÉDERM® injectable gel is available in two formulations— JUVÉDERM® Ultra for versatility in contouring and volumizing facial wrinkles and folds, and JUVÉDERM® Ultra Plus, a more robust formulation for volumizing and correcting deeper folds and wrinkles. This allows your healthcare professional to tailor treatment to meet your unique needs.
Looking for non-surgical advancements in facial rejuvenation? Well, look no further. With the recent introduction of a revolutionary filler known as Restylane®, patients in the United States now have access to a product that has been used in Europe for several years showing great success in achieving facial rejuvenation with injections. While there are numerous injectable fillers on the market today, many of them have their drawbacks restylaneincluding allergic reactions and relatively short life spans. Restylane® is a safe and natural cosmetic filler that is immune to these drawbacks given its unique chemical composition. In December 2003, the U.S. Food and Drug Administration approved the use of Restylane for the treatment of facial wrinkles. Additional applications of Restylane® include:
It is important to note that while Restylane has been approved to enhance the appearance and fullness of the lips, the safety and efficacy of this application of Restylane® has not been established by the FDA.
What is Restylane® Made of?
Restylane® is produced as a clear gel substance and is injected directly beneath the surface of the skin.Produced and marketed by a company in Sweden, Restylane® is the first, and currently the only, dermal filler approved by the FDA that is made of a biodegradable hyaluronic acid. Hyaluronic acid is a naturally occurring substance present in all living organisms. This natural acid provides volume and fullness to an organism’s epidermis (i.e., skin). Restylane® is produced as a clear gel substance and is injected directly beneath the surface of the skin. Through the introduction of Restylane® to the treatment area, the hyaluronic-based gel adds natural volume and lift resulting in smoother wrinkles and less prominent folds. Moreover, and what distinguishes Restylane® from other dermal fillers, is the way in which Restylane® permeates the dermal tissue and naturally binds to water molecules. Through this action, the modified water molecules assist in achieving and maintaining volume possessing a natural appearance. Over time, Restylane® is gradually degraded by the body and dissolves without any residue or trace. Restylane® treatments results are immediately visible and typically last about six months. Factors such as the patient’s age, skin type, etc., will effect how long Restylane® treatments results are sustained. Moreover, most patients require only one Restylane® injection to obtain optimal results. Occasionally, additional treatments may be required to achieve the patient’s desired outcome. During the consultation visit with the cosmetic surgeon, the number of required treatments will be addressed.
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