Botox injections are more convenient and less painful than other procedures for reducing wrinkles and making your face look younger (chemical peels, dermabrasion, laser resurfacing, face-lift). Keep in mind that the effects of an injection last only a few months. Botox Cosmetic is a safe, reliable injectable medication, which blocks the actions of certain nerves. For wrinkles this means relaxing the muscles that crease the skin or pull the skin down. Botox is denatured easily by bubbling or agitation; gently inject the diluent onto the inside wall of the vial. Discard the vial if a vacuum does not pull the diluent in.
Botox Cosmetic, for example, is currently being used by physicians to treat facial wrinkles other than those specified by the FDA. Consumers should be aware, however, that this "off-label" use has not been independently reviewed by the agency, and the safety and effectiveness of Botox injections into other regions of the face and neck, alone or in combination with the frown-lines region, have not been clinically evaluated. Botox was first reported in the medical literature to be effective with migraines in 1998. Botox is the brand name of a toxin produced by the bacterium Clostridium botulinum . In large amounts, this toxin can cause botulism , which you probably associate with food poisoning .
Botox injections can offer great results and many happy patient outcomes, but there is risk involved, and there is always a small chance that something could go wrong. When considering Botox, you need to weigh the good with the bad and decide whether or not the potential for complication is worth the pay off. Botox and Botox Cosmetic products should only be used under specialist supervision in those patients and should only be used if the benefit of treatment is considered to outweigh the risk. Botox contains albumin, which comes from human blood. There is a very rare risk of getting a viral disease or a central nervous system disease called Creutzfeldt-Jakob disease from products with albumin.
Botox can help eliminate the teeth grinding by relaxing your jaw muscles. Botox poses little to no risk. It has been used for decades to treat eye spasms, dystonia, cerebral palsy, and more recently, wrinkles. Botox — the brand name for medicinal botulinum toxin type A — is the purified low-concentration form of the toxin. When injected in small doses into specific muscles, Botox blocks the chemical signals that cause muscles to contract.
Eyelid surgery is very safe but complications can occur when patients over exert themselves. When using laser and radiowave techniques like Dr. Eyelid surgery is usually performed under local anesthesia. However, the surgeon or patient may prefer to use general anesthesia. Eyelid surgery is also a great option for people who'd like to rejuvenate their appearance but aren't ready for a facelift. Wrinkles around the eyes or drooping forehead skin cannot be eliminated by a blepharoplasty; for those problems, BOTOX Cosmetic , a forehead lift , or a facelift may be the answer.
Eyelid surgery is not painful, but the swelling and sometimes tightness is uncomfortable. During the first 48-hours ice compresses to the eyelids will help significantly with reduction of swelling. Eyelid surgery is popular with both men and women and can be used to correct drooping, hooded or puffy eyelids and under eye bags that are either hereditary or caused by ageing. This can be purely for cosmetic reasons or because the drooping lids are obstructing their vision. Eyelid surgery is typically performed on an outpatient basis. Some procedures, such as biopsies or removal of small growths, may even be performed in a clinic setting.
Eyelid surgery is recommended for those patients who have excess fat deposits or bags above or below the eye. These puffy fatty deposits can make you appear tired or angry. Eyelid surgery is also called blepharoplasty. This involves the removal of fat usually along with excess skin and muscle from the upper and lower eyelids. Eyelid surgery is very safe but complications can occur when patients over exert themselves. It is very important to avoid strenuous activities that require bending or lifting for a week after surgery.
Cosmetic eyelid surgery offers men the same benefits as it does women – improved sight, the appearance of bigger eyes, and elimination of unsightly bags. Male eyelid surgery can be a very beneficial procedure for men who qualify as good candidates. Cosmetic blepharoplasty surgery is customized for every patient, depending on his or her particular needs. It can be performed alone involving upper, lower or both eyelid regions, or in conjunction with other cosmetic surgical procedures of the eye, face, brow, or nose. Cosmetic eyelid surgery can remove the excess skin, fat, or both, from around your eyes.
Asian eyelids have specific charateristics, unique anatomy, and natural lines that should not be dramatically altered. Asian Americans who disagree with Mura's interpretation often point out that a large percentage of Koreans, Japanese, and Chinese are born with creased eyelids, although they certainly tend to be shaped differently than those of, say, Caucasians. In fact, in some regions, such as in southern China, as many as 70 percent are born with them.
Plastic surgery may also increase the chin, bend of cheeks, remove a double chin or simply reduce it. Plastic operations enable us to change the shape of breasts and buttocks, remove fat from belly, arms and hips. Plastic surgery is growing in popularity; plastic surgery was originally mostly for women. But men are electing to have plastic surgery at a rapid growth rate.
Plastic surgery is all too common in this modern world. Women of varied ages naturally want to look good, so they take advantage of advances in science to alter their bodies ? Plastic surgery procedures greatly range in cost. By understanding the cost, people are able to decide what procedures they can have done. Plastic surgery is a serious and subtle art, helping people adapt in their environment more easily and feel happier. Specialists of plastic surgery can eliminate such congenital defects as harelip, blood vessel nevus, sticking-out ears, etc.
Plastic surgery isn't something to rush into. If you're thinking about plastic surgery, find out as much as you can about the specific procedure you're considering and talk it over with doctors and your parents. Plastic surgery as a specialty evolved tremendously during the 20th century in the United States. One of the founders of the specialty, Dr. Plastic surgery has become a part of our society. Many people, not just the rich and famous, undergo some type of cosmetic plastic surgery procedure.
We only get one chance at a first impression, and the person who projects the best self-image makes the best impression. In today's competitive society, people recognize the importance of self-improvement, whether it is for social or professional reasons. Exercise, skin care and nutrition are important but can only do so much. Real structural change requires more. In a sense, cosmetic surgery offers a second chance - the opportunity to defy both the calendar and genetics. Here I have compiled some of the most successful techniques used to achieve this goal.
Rejuvenation Techniques
Facelift (rhytidectomy)
Over the past few years, the term facelift has become a topic of increased interest and discussion. The cumulative effects of time, gravity and heredity show on any face. The facelift operation itself, also known as rhytidectomy, is performed to correct double chins and sagging jowls. The modern-day, long-lasting facelift operation, involves the permanent removal of undesirable accumulations of fat. As well, sagging muscles and connective tissue are repositioned and re-supported.
Because excess fat is now removed in the operation, patients no longer need to lose weight before surgery. In fact, for people who previously had chubby cheeks or a fat neck, one of the benefits of facelift surgery is an apparent loss of weight following surgery. The overall effect is a younger, fresher and more vibrant (yet natural) appearance.
Often lumped under the term facelift are a group of operations designed to rejuvenate faces that show signs of aging. These include blepharoplasty (eyelid surgery), brow and forehead lift, mid-face lift, and skin resurfacing, among others.
48 year old woman before and after
facelift, browlift, and chin augmentation
Blepharoplasty
Americans stress eye contact and believe that they can judge a person’s character by what they see in their eyes. While people talk most about facelifts, the most popular age reversing operation among my patients these days involves the eyelids. Heavy, ‘hooded’ (drooping) upper eyelids and baggy lower eyelids make people look tired, old, and certainly past their prime. The surgical correction known as blepharoplasty can remove the fatty pouches that cause these unfortunate problems. When present, skin that has become stretched over the years can also be removed. Upper eyelid drooping, which sometimes partially obscures vision, is corrected by removal of excess skin, muscle and fat. Incisions follow natural contour lines in the upper eyelids, and in the lower lid can be made on the inside, so there is no scar at all. In some cases, circles under the eyes can be filled in and the lids tightened.
Brow and Forehead Lift
A pleasing eyebrow shape and arch is associated with youth and beauty. On the other hand, an unfavorable eyebrow shape and angle can make a person look tired, worried or angry. The brow and forehead lift, in addition to lifting the eyebrows back to where they belong, smoothes out a deeply furrowed and pinched forehead. I prefer the high-tech endoscopic method, which is a big improvement to older more invasive surgery, because it requires only very small incisions within the hair. A tiny video-connected scope is then passed under the skin; the tissues are released, repositioned, and secured into position. With this advanced procedure I no longer make the old fashioned long incision across the top of the head and never remove scalp or hair. The benefits are brighter, more open eyes, a fresher, and more pleasant and alert demeanor.
Mid-Face Lift
The mid-face is the area immediately below the eyes, next to the nose and above the lips. It is left behind by the facelift discussed above, which benefits the jowls, under the chin, and the neck. The mid-face lift corrects sagging in this important area in the center of the face, helps circles under the eyes, and enhances cheekbone definition. I perform the mid-face lift with the only incisions in the scalp and inside the mouth under the lip. In other words, it can be done with no facial scars. The mid-face lift can be done alone or in combination with any of the other facial rejuvenation procedures.
Botox
Botox is used for the treatment of frown lines, forehead furrows, "crow’s feet", and lines and wrinkles of the lower face. Botox has proven to be a very popular nonsurgical cosmetic treatment. The type of lines and wrinkles that respond to Botox injections are those caused by muscles—specifically those muscles that contract during facial expressions such as frowning or squinting. It works by relaxing the muscles that cause the lines so wrinkles smooth out. There is no downtime, and patients can immediately resume normal activities.
Skin Resurfacing
Skin resurfacing uses either a laser or special chemicals to smooth the skin, reduce wrinkling, and even out the complexion. I personally use the newer Erbium: YAG laser, which has proven to be a kinder and gentler alternative, with much faster recovery than the CO2 laser.
Some people prefer to correct one thing at a time -- what one of my patients once called "weeding the garden." Others want a more dramatic improvement; they have as much done as necessary and feasible at once so as to achieve maximum benefits. It is an individual choice, and one of the reasons a thorough consultation with a well-qualified, experienced, sympathetic plastic surgeon is so important. I have found that video imaging assists in creating plans for facial surgery that meet each individual's specific needs and desires.
Breakthroughs in anesthesia methods and monitoring devices have made it possible for all of these operations to be performed on an outpatient basis. This is a positive step because patients feel more comfortable and heal faster in this environment. In addition, outpatient procedures reduce expenses overall.
Techniques for the Body
Body Contouring Surgery
In the months leading up to the summer, I see an influx of women seeking to re-contour their figures. They are usually trying to plan ahead, getting their ‘problem areas’ taken care of well in advance of spring and summer's more revealing clothing styles.
According to statistics kept by the prestigious American Society of Plastic Surgeons, Liposculpture, more commonly known as liposuction, has become the most frequently performed cosmetic surgery procedure. I choose to perform the tumescent form of liposculpture, which can be done on an outpatient basis.
In liposculpture, a combination of saline (saltwater) and local anesthetic is first flooded into the areas to be contoured. Working through tiny incisions just large enough to fit the thin liposculpture vacuum tube, fat cells and some fluid are then gently swept away by suctioning back and forth under the skin. Liposculpture is truly a matter of sculpting the human form; it effectively removes unwanted fat from areas that are often resistant to diet and exercise. These can include the neck, upper arms, chest, sides, abdomen, thighs, hips, knees and ankles.
Other procedures for figure improvement include abdominoplasty (tummy tuck), breast lift, breast reduction, and--last but not least--cosmetic breast surgery. Saline implants, which have now replaced silicone gel implants, are used both to enlarge and to enhance shape. Following surgery, many of my patients are particularly happy that the tops of their bathing suits fit as well as the bottoms.
Any of the procedures described in this article can potentially help to improve physical appearance and enhance self-image. But no matter what procedure you choose, be sure to do your homework and choose a qualified, experienced plastic surgeon.
What is this obsession about beauty that makes us alter our bodies to please the eyes of other people? Is it the fault of television programs and huge billboards that brainwash us everyday to look good? Are they the ones setting the correct meaning of what it beautiful or not?
You have to agree, people are social beings. We belong to different groups in our society such as family, community, work group, sports group, religious group, and our circle of close friends. The people in our lives influence our thoughts and beliefs. For example, if you have intimate friends who are drug addicts, it’s probable that you will become a drug addict too. So if you are frequently associated with people who are obsessed about beauty, you will consider plastic surgery too, just to be an important part of the circle.
Not too long ago, only rich women in their fifties or sixties are thinking about plastic surgery. The famous ones are Botox, liposuction, and face lift. But today, younger women are dipping into the world of artificial beauty too. Can you imagine 18-24 year olds saving every penny they’ve got to get a breast implant? What about those fat young girls who are toying about the idea of liposuction and tummy tuck instead of eating proper diet and exercising to lose weight?
Internet statistics confirm this phenomenon. Majority of visitors to plastic surgery sites are within this age demographic (18-24), and it has been increasing every year. While older women now are visiting sites on keeping healthy and preventing diseases, the young generation is deeply focused in improving outer beauty such as skin care, weight loss, bodybuilding, and of course, plastic surgery.
Although, there is one thing that prevents the majority of these young people from going under the surgeon’s knife: high cost. In fact, a more detailed search statistic reported that common Google searches include the word “cost” such as “breast augmentation cost,” “breast implant cost,” or “plastic surgery cost.” This indicates that even though outer appearance is an obsession, economic consideration is still the number one show stopper, especially in the face of the declining U.S. economy.
Another reason for delaying plastic surgery is the fear that surrounds this procedure. Although there are a lot of successful operations already, there are also risks associated with it. We can never remove the fact that some doctors make mistakes, or the possibility that our body will react adversely to the operation.
Have you heard of the tragic story in the U.S. where Stephanie Kuleba, a cheerleader (18 years old) died of complications as a result of going through a breast augmentation procedure? Scary! And there were many more that ended with the same fate.
So if you are young, think really hard before you decide to have plastic surgery. Remember that you still have a long life ahead of you. Would it be worth it? Do you really think everybody needs to have a perfect body? Maybe you can learn from the old verse that says “Beauty is in the eyes of the beholder.” Just highlight what’s good in your body today, and your beauty will shine through.
Three years ago, when a 15-year-old British girl decided to get breast implants for her sixteenth birthday, the story made headlines around the world. Since then, media reports have continued to speculate that cosmetic surgery, once the exclusive domain of wealthy older women, is a trendy new option for any teenager with an adolescent hang-up.
Dr. Darrick Antell, a top New York City plastic surgeon, says he has seen an increase in the number of teenage patients but cautions against calling it a trend. “One of the main reasons for the increase is visibility: today’s teenagers are growing up with parents who have had cosmetic surgery, so they see and hear about it more. The media has also done a good job of making people aware of the procedures available. Another reason is acceptability. In a way, plastic surgery has come out of the closet,” Dr. Antell says.
When details of cosmetic procedures are frequently discussed on talk shows and published in magazines, it’s not surprising that they filter into our consciousness. “Sometimes when I’m out to dinner with my friends, we’ll play a game called ‘What would you have done?’ where we sort of daydream and discuss what we would do if money was no object and the procedures were safe,” says 18-year-old Alison Preiss, an Ontario high school student. While Preiss doesn’t think she could actually go through with a procedure, she says it could go either way. “I could grow up to realize that there are more important things than my nose, or it could really bother me to the point where I decide to have surgery. I suppose it depends on my lifestyle and career choices,” Preiss says.
Suzanne Ma, a 19-year-old Ryerson University student, has considered a double eyelid procedure popular in Asia. “I’m Chinese, and I don’t like my eyes. I don’t have double eyelids, so I feel that my eyes look a lot smaller than they really are. My concerns are not entirely for cosmetic reasons. With my heavy eyelids, my eyelashes don’t grow out properly. Some of them get trapped under the eyelids and it’s very easy for me to get an infection,” Ma says.
As in North America, plastic surgery is booming overseas, especially in wealthier Asian countries like Taiwan and Korea, where it is seen as a way to improve career prospects and self-confidence. In China, women and some men are paying thousands of dollars to have a brutal surgical procedure performed that lengthens their legs so they can fulfill height requirements often used to narrow down the number of job applicants.
Although reasons for cosmetic surgery range from getting a better look to improving job prospects, often the common factor among patients is more than skin deep. “Teenagers who are thinking about having plastic surgery to change the way they look are often addressing issues of self-esteem,” says psychotherapist Dorothy Ratusny. “Between the ages of 13 and 19, there’s a lot of emphasis on peers and what others think of you. It’s also a time when things such as not being part of the popular crowd, changes in financial situation and divorce can negatively affect a teenager’s self esteem.”
Cosmetic surgery may have a positive impact if your body image is consistently tied to a negative focus on a particular facial feature or body part. Dr. Antell says, “The classic case is a teenage patient of mine who had reconstructive surgery to correct a significant discrepancy between her upper and lower jaws. When she came into my office for the initial consultation she was constantly looking at the floor. After the surgery, she was looking up and smiling. Now she’s singing in her local school group.” Dr. Antell is careful to point out that there are murky areas. “Liposuction is one of those areas. So is breast augmentation because you’re not really sure that the teenager has stopped growing yet. But there are exceptions, for example, if a patient has breast asymmetry.” Dr. Mitchell Brown, a plastic surgeon at Sunnybrook and Women’s College Health Sciences Centre in Toronto says, “Correcting breast asymmetry, when women develop breasts that are different in terms of shape and size, can be appropriate for teenage girls because it causes a very significant psychological impact on them during their developmental years.
Doctors are very aware of the psychological drama affecting our lives and it has become a very important factor when evaluating a patient. Dr. Brown says, “The key thing from my perspective is to assess physical, emotional and psychological maturity before treating a patient. I spend a great deal of time with my patients, regardless of their age, to determine that they have thought out their concern carefully and have reasonable goals and expectations.” In other words, cosmetic surgery can improve a patient’s body but it won’t necessarily improve their self-image or guarantee happiness. Dr. Antell says, “I’ve done liposuction on a Sports Illustrated swimsuit model. This is somebody most people would think looked perfect. But she was very insecure. She didn’t see herself the way others did. I can’t give people confidence.”
So, if you’re considering cosmetic surgery you need to ask yourself what you hope to achieve because it’s not going to be the one magic solution that makes everything better. In fact, it may even change you for the worse—just surf the Web and read the thousands of horror stories from people hoping to find peace of mind or happiness by going under the knife.
Dr. Ratusny says, “[Teens] need to be really realistic with the fact that cosmetic surgery may be only one piece of many things that serve to improve aspects of themselves. There may be physical changes but the real change begins with who they are inside.”
In the late 1980s plastic surgeons and the public were introduced to a new concept, filling in wrinkles with collagen. Collagen came from cows and was treated to make it inert so that it could be safely injected into humans.
It worked, but had several significant drawbacks. Since it was an animal protein, there was the risk of an immune response. Anyone who desired collagen injections was skin tested and waited weeks to make sure they didn’t react to the treated protein. In addition, collagen was expensive and only lasted up to several months. For many years this was all that was available to the plastic surgeon in the realm of fillers.
However in recent times several new fillers have come onto the market, and it can be difficult for patients to know which product is best for their needs. Here is a run down on the most popular fillers:
Hyaluronic acid based fillers (Restylane, Perlane, Juvaderm, Elevess) Calcium hydroxlyapatite fillers (Radiesse) Human and animal based collagen (Cosmoderm, Cosmoplast, Artefil) Others (Sculptra, Silicone)
Restylane
Restylane was introduced for use around the mouth after FDA approval in 2003. It was innovative in that it didn’t require a skin test for allergies like the old bovine collagen fillers. This hyaluronic acid gel is based on the same hyaluronic acid in the human body, thus reducing the risk of side effects. Youthful skin has lots of hyaluronic acid which helps plump up the skin, but we lose it as we age. Restylane helps restore that volume. It can be injected into the fine lines or deep folds of the face, as well as the lips. With over 1.4 million people who have already received this treatment, it is popular because there’s minimal down time and the results can be seen immediately. Although it has been proven clinically safe to use, those with severe allergies should avoid the use of Restylane. It normally lasts between six months to one year.
Perlane Perlane entered the market in May of 2007. Also a hyaluronic preparation, Perlane is similar to Restylane, but slightly thicker. It is intended for injection into the deeper layers of the skin. The FDA approved of its use for mild to moderate lines around the mouth. Although clinical studies of Perlane have shown no allergic reactions, it should not be used by anyone who has had previous severe allergies. Pregnant or nursing women should also avoid use of Perlane. It lasts approximately eight months to one year.
Juvaderm Juvaderm Ultra and Juvaderm Ultra Plus are also hyaluronic acid fillers that are FDA approved for cosmetic purposes. Ultra is used on very fine lines, while Ultra Plus, dense and thicker in consistency, is made for the deeper lines and folds of the face. The duration for both is about eight months to one year.
Elevess Elevess is a relative newcomer to the field of hyaluronic acid fillers, but it comes in a higher concentration, which adds to its durability. It also contains lidocaine, a local anesthetic that improves patient comfort during injection. Elevess was created to be injected in the mid to deep layers of the skin, thereby alleviating the moderate to severe folds and lines, such as those around the nose and cheeks. Patients with severe allergies should not use Elevess.
Radiesse This water-based gel with suspended calcium particles is made of a chemical called hydroxylapatite, which is compatible with the bioidentical substance in our bodies. It does not require a skin test. Perfect for facial contouring and for plumping the deep folds of the skin, Radiesse will usually remain in place for ten to fourteen months. Because Radiesse is white in color, it cannot be used in the lips or for fine lines that require injections close to the skin surface. The white color would show through the skin layers.
Cosmoderm and Cosmoplast Made from purified human based collagen, these fillers are FDA approved and can be injected without a skin test. They come mixed with a local anesthetic, and therefore are less painful to inject. Both fillers are very pliable, which leaves a natural looking result. Cosmoderm works best on the fine lines around the eyes and the vertical lines above the lips. Cosmoplast, a more dense filler, works in the deeper lines of the face and the furrows between the eyes. Although Cosmoderm and Cosmoplast are less expensive than the other fillers, they don't last as long. The collagen is absorbed and wrinkles can return within three to six months.
Artefil Collagen is the main protein found in connective tissue, but Artefil comes from bovine collagen, which requires skin testing before it can be injected. The advantage to Artefil is that it contains microscopic spheres that develop a matrix for your own body’s collagen to grow on. Unlike the other fillers that are reabsorbed into the body, this filler is permanent. That’s both the good news and bad news. If you like your result, it’s permanent. If you don’t like your result, it’s still permanent. Artefil is also more expensive than the other fillers.
Sculptra Different than all the other fillers is Sculptra, made of poly-L-lactic acid. It was created not to fill in wrinkles, but to increase volume in hollow cheeks, sunken eyes and facial folds. Approved by the FDA for medical use, it is most often used in AIDS patients who lose facial contour due to loss of facial fat. This synthetic material lasts up to 2 years, but needs initial maintenance to get an outcome that is satisfactory.
Silicone The FDA does not condone Silicone injection for the treatment of facial lines and defects. There is a silicone preparation available to ophthalmologists to be used in the treatment of eye disease, but some doctors use this preparation for treatment of facial lines contrary to the recommendations of the FDA.
Verdict Facial fillers have been around for a relatively short period of time. Their biggest drawback right now is their temporary nature. I believe we will see many changes and enhancements in the future. I expect that in the next several years longer lasting, or even permanent fillers will be developed.
About the Author Dr. Corwin has been practicing Plastic and Reconstructive Surgery in the Conejo Valley since 1977 and specializes in cosmetic surgery
We only get one chance at a first impression, and the person who projects the best self-image makes the best impression. In today's competitive society, people recognize the importance of self-improvement, whether it is for social or professional reasons. Exercise, skin care and nutrition are important but can only do so much. Real structural change requires more. In a sense, cosmetic surgery offers a second chance - the opportunity to defy both the calendar and genetics. Here I have compiled some of the most successful techniques used to achieve this goal.
