Is a rhinoplasty right for you?

Ongoing dissatisfaction with one or more physical features of your nose, as well as functional or aesthetic problems due to injury or trauma, are just some of the common reasons why patients decide to undergo rhinoplasty surgery.

Commonly known as a “nose job,” rhinoplasty consistently ranks among the top ten most sought-after plastic surgery procedures. While it may seem like a straightforward surgery, rhinoplasty requires a high level of experience and training to produce superior quality results. If you do decide that a rhinoplasty is right for you, it is important to seek a qualified plastic surgeon that has an eye for aesthetics and detail.

What is rhinoplasty?

Your nose is composed of cartilage, soft tissue and small bones, all of which work together to create the shape and appearance of your nose. Any changes made to any one of these components can significantly alter the appearance of your nose, which is why rhinoplasty can be an intricate, complicated procedure.

During rhinoplasty surgery, your plastic surgeon works on, and with, these individual parts, utilizing a range of techniques to alter the nose both aesthetically and functionally. The techniques used for your rhinoplasty will depend on both your personal goals as well as on the natural anatomical makeup of your nose and any previous trauma or surgery that might have occurred there.

What are the reasons to consider a rhinoplasty?

To change the way your nose looks

Many people considering rhinoplasty want to change the shape and appearance of their nose, which is known as cosmetic rhinoplasty. Depending on the anatomical makeup of your nose and the look one is looking for, cosmetic rhinoplasty may only involve minor changes in structure that are reflected in visibly noticeable improvements.

However, in some cases, altering multiple components of the internal structure of the nose will be necessary to achieve the look you want. Cosmetic rhinoplasty is typically done to change the overall shape of the nose, making it wider, larger, narrower or smaller – with the goal being to improve the overall proportion and balance of the face. To that end, the tip of your nose can be altered as well.

To improve your breathing

Injuries, genetic abnormalities and growths inside the nose can impede the flow of air into the nose and make breathing difficult. Under these conditions, rhinoplasty can include work on the passageways that the air takes and the changes in shape or structure of the nose are designed so air can flow through normally.

This type of procedure will likely involve altering the septum. The septum is the long, large piece of cartilage tissue that runs along the very center of the nose. Changing the position or size of the septum typically is considered a medically necessary surgery because the goal entails a marked improvement in function, and may be covered by health insurance. Sometimes, work on the soft tissue inside the nostril can improve the airflow by widening the space between the septum and the sidewalls and soft tissue of the nose, commonly referred to the nasal valve area.

To complement your ethnicity

Ethnic rhinoplasty is an approach that changes the appearance of the nose, but in doing so, remains true to the patient’s ethnicity – enhancing one’s nose and balancing your features without sacrificing the various nasal features that characterize different ethnicities. The objective is to give an individual a beautiful, natural-looking nose that remains in harmony with the rest of the face and unique features.

Are you a good candidate for rhinoplasty?

The decision to undergo rhinoplasty is a personal one, based on dissatisfaction with certain features of one’s nose and the desire for a different look. The presence of one or more undesired nasal features may well make you a good candidate for rhinoplasty, some common reasons include:

  • A crooked septum that makes the nose appear off-center
  • A bump on the bridge of the nose
  • A wide nose
  • A thick nasal tip, asymmetric, or an overly projecting, or even drooping, tip
  • Cosmetic irregularities due to injury or trauma

Who should you see for a rhinoplasty?

While there are many surgeons who might be technically qualified to perform rhinoplasty procedures, you want to entrust the alterations of the focal point of your face to someone with extensive experience and training in the procedure. You want to make certain that the plastic surgeon you choose possesses the level of expertise necessary to deliver the superior results you expect.

Considering how precise this procedure can be, it’s especially important to choose a plastic with extensive training and experience in aesthetic surgery of the face – being a member of the American Society of Plastic Surgeons and board certified by the American Board of Plastic Surgery helps assure one that the surgeon is qualified and undertakes continual education of the procedure.

The views expressed in this blog are those of the author and do not necessarily reflect the opinions of the American Society of Plastic Surgeons.

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What’s behind the cost of Botox and injectable fillers?

cost of Botox and injectable fillers

The price of popular cosmetic treatments like Botox and dermal fillers is a factor that many people take into consideration before booking their appointment. While you certainly want to choose a provider and treatment option that fits within your budget, you also need to be careful of providers who lack sufficient training and expertise and who could put your health and safety at risk.

To help you get the most bang for your buck while ensuring you’re getting an authentic product administered by a trained professional, consider these tips.

How much do fillers and Botox cost?

Knowing what the average cost of fillers and Botox in your area can help you gauge whether or not a certain provider’s price is fair and/or suspiciously low. According to 2018 pricing data from the ASPS, the average cost of hyaluronic acid fillers is $682 per syringe. Most people require more than one syringe to achieve the desired results.

Botox, on the other hand, is measured in units and typically costs around $10 to $15 per unit. An average dosage of 30-40 units might be used to treat the forehead and eye area, for example, making the total cost around $300 to $600.

Keep in mind, however, that these averages can vary based on your location. So, do your research by comparing prices from a few reputable providers in your area before making a decision.

If you are working cosmetic treatments into your recurring budget, you’ll also want to factor in approximately how long each treatment will last before requiring a touch-up visit. In general, hyaluronic acid fillers can last anywhere from 6 to 18 months, while Botox usually lasts 3 to 6 months. So, while the upfront costs of fillers, for example, might seem higher, know that you may not need another treatment for a year or more.

Why “bargain shopping” for Botox isn’t your best bet

When pricing out an injectable filler or Botox treatment, consider that the cost of the product is only one component of the total price. You’re also paying for a trained, certified and experienced professional to properly administer those products to safely achieve beautiful, natural-looking results.

For this reason, bargain hunting for Botox, fillers and other cosmetic treatments isn’t recommended. It is unfortunately still common to hear horror stories of untrained, unlicensed providers offering cosmetic services at a steep discount and causing long-lasting damage to patients. This is a key reason why choosing a board-certified plastic surgeon, or a medical spa facility operated by a board-certified plastic surgeon, is one of the most important decisions you can make when shopping for injectables.

A few red flags to look for when choosing a filler or Botox provider include:

  • Prices that seem too good to be true
  • Lack of information or before and after pictures on their website or in their office
  • Refusal to show you the product packaging or labeling
  • A dirty, disorganized office or clinic

It is also worth mentioning that while “Botox parties” have become popular, these events are not a safe way to receive injections unless they are carefully administered in a clinic environment. Botox, fillers and other professional cosmetic treatments should always be performed in a sterile medical office and by a trained professional.

How to save on Botox and fillers the safe way

Fortunately, there are many different ways to help make the cost of fillers and Botox more affordable while still getting safe, high-quality results. The best way to save is to look for promotions from your trusted provider – again, being wary of low-ball price offers from questionable sources. Some plastic surgeons will offer a discount if you purchase multiple syringes or units, or discounts when packaging surgical and nonsurgical services. Others may have rewards or loyalty programs that make treatments more affordable over time.

Another option is to discuss financing during your consultation. Some offices may offer financing options so that you can pay for your treatment in smaller chunks over a longer period of time, rather than paying in one lump sum upfront.

If the cost of fillers or Botox is a concern for you, discuss your specific goals with a board-certified plastic surgeon and don’t be afraid to be honest about your budget. Working together, you can find the right treatment options that will help you look refreshed without breaking the bank.

The views expressed in this blog are those of the author and do not necessarily reflect the opinions of the American Society of Plastic Surgeons.

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Finding the right plastic surgeon for you

finding the right plastic surgeon for you

Plastic surgery has come a long way in the decades since it first became popular. Not only have plastic surgery techniques advanced in sophistication and safety, but both men and women have also become much more comfortable with the idea of enhancing their appearance via plastic surgery.

In fact, plastic surgery procedures like breast augmentation and liposuction are consistently rated as the most popular surgeries worldwide. In 2018 alone, plastic surgeons in the United States saw over 250,000 patients for each procedure.

If you’ve decided to take the plunge, you’ve probably spent a lot of time wondering how to find a good plastic surgeon. Even if you perform an internet search for phrases like “find the best plastic surgeon in Seattle” or “the best plastic surgeons near me,” there are likely dozens of options for you.

Finding the right plastic surgeon for you

The truth of the matter is that there is no “one size fits all” practice or surgeon. Even if you’re getting the exact same breast implants as your neighbor, you may find that her surgeon may not feel like the right fit for you, and that’s okay. Plastic surgery can be a fantastic and positive experience, and potentially life-changing, so remember not to rush the process. It’s also a very individualized experience, so what makes sense for your neighbor may not make sense for you. Experienced surgeons understand this and will not pressure you into making a decision or rush you into a procedure before you’re ready.

There are several criteria that you can use to judge whether or not a particular surgeon is right for you and your procedure. Finding a qualified plastic surgeon can be easier when you look for these minimum criteria:

Look for board certification in plastic surgery

Any plastic surgeon who ends up on your short list should be board-certified by the American Board of Plastic Surgery (ABPS). In fact, before you go through the process of scheduling a consultation, you’ll want to check to see if the surgeon in question has the proper credentials.

Medical credentials can often be confusing if you’re unfamiliar with the jargon, so it’s helpful to know what to look for. In your search, look for board certification from the American Board of Plastic Surgery. This means he or she has undergone a rigorous board certification process by the only plastic surgery board recognized by the American Board of Medical Specialties.

Additionally, while you’re at it, check to see if the provider you’re considering is a member of the American Society of Plastic Surgeons. While not a certifying organization, ASPS is well-respected, and its members must also maintain a rigorous set of training and patient safety standards to qualify for membership.

These credentials are important markers that signal you can trust the surgeon in question to be highly trained and qualified to perform your procedure. This is especially crucial in light of the fact that many untrained doctors are calling themselves “cosmetic surgeons” these days.

Study the surgeon’s style and approach

In addition to training and medical knowledge, cosmetic plastic surgery requires some artistry as well. Because every woman’s body is unique, the “best” plastic surgeon for a breast augmentation for example is much more likely to be one whose style of work is in line with your aesthetic goals and who can tailor a treatment to your unique situation to meet those goals. This is one reason why you can’t just search a phrase like “the best plastic surgeons near me” on the internet and choose the top result.

Good plastic surgery requires the provider to be able to customize his or her treatment to your situation and needs. Review the surgeon’s gallery of patient cases and before and after photos to get a sampling of his work and look for a variety of excellent results.

During consultations, don’t hesitate to ask for additional pictures, case studies or patient testimonials. Patient reviews on patient forums can also provide honest feedback from patients regarding their experiences with potential surgeon candidates.

Vet the facility

An accredited and accommodating facility is another important thing to look for when choosing a plastic surgeon.

Because cosmetic plastic surgeries can generally happen outside of the hospital, it’s especially important to ensure that the facility your procedure will take place in is held to the highest standards of safety, quality and patient care.

In order to find out if a facility is accredited by a credible organization, you should look for at least one of the following certifications:

  • State licensure
  • Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
  • American Association for Accreditation of Ambulatory Surgery Facilities (AAASF)
  • Accreditation Association for Ambulatory Health Care
  • Title XVIII Medicare participation

Find someone you trust

Much like finding the right family doctor or personal trainer, it may take a few tries before you meet a surgeon you feel comfortable enough with to trust. Having a personal rapport and ease of communication with your surgeon and surgical staff can mean the difference between a good plastic surgery experience and a great one.

When you find a surgeon that you connect with, you’ll be able to feel more confident about your surgery and you’ll be able to have open honest and important discussions about aesthetic goals, lifestyle, overall health and any questions or concerns that you might have.

The right provider will also outline a realistic timeline for recovery based on your medical history and help you through the recovery process.

Look for honesty

Finally, it’s not a plastic surgeon’s job to tell you what you want to hear. The best surgeons will give you honest, straightforward guidance on the best approach to your situation and the realistic results you can expect.

Choose a qualified plastic surgeon for your procedure

Understanding how to find a good plastic surgeon is the first step towards achieving your aesthetic goals. Choosing a safe, experienced, board-certified plastic surgeon that you connect with can help you on your journey towards a happier, more confident you.

The views expressed in this blog are those of the author and do not necessarily reflect the opinions of the American Society of Plastic Surgeons.

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Best minimally invasive procedures to look your best for the holidays

best minimally invasive procedures to look your best for the holidays

Are you having trouble looking your best for holiday gatherings due to cold weather, dry skin, dull complexion and everything in between? Don’t fear, minimally invasive procedures are here!

Minimally invasive cosmetic procedures are a fantastic way to look rejuvenated and brighten up your look during the holidays with minimal to no downtime. An added perk is that most plastic surgeons offer holiday pricing or bundled packages to help save money while achieving glowing skin.

Skin rejuvenation

Winter can often dry out your skin, cause dullness and show more wrinkles. Improved skin quality can be quickly achieved with a chemical peel in the office, a microneedling procedure or even a laser treatment.

The best treatment for you depends on your skin type, previous treatments and other factors. Make sure to tell your plastic surgeon about your skin care goals, and they will help you pick a procedure that provides the best results with the least recovery time, allowing you to maximize your time off and enjoy the holidays looking refreshed.

Skin care products will help with overall skin health and make perfect gifts for you and others. Often, optimal skin care before and after any treatment will help you get better results and recover faster after any office treatment.

Botulinum toxin

Wrinkles caused by muscles, such as the crow’s feet area or the forehead, respond well to neuromodulators. The FDA-approved neuromodulators available in the US are Botox, Dysport, Jeuveau and Xeomin. Make sure to ask your plastic surgeon which one is best for you. Just a few days after the injections, your wrinkles will look substantially better.

Dermal fillers

Deeper wrinkles in the lower face or any loss of youthful facial features often respond well to dermal fillers. A quick injection in the office will give you immediate results and should last for months, and sometimes years, to help perfect your look for the holidays and beyond!

Common brands available in the US include Juvederm, Restylane, Radiesse, Sculptra, Versa, Belotero, Bellafill and even your own fat! These dermal fillers all have different factors for placement, how long they last, the need for allergy testing and other factors, so talk with your plastic surgeon about the best option for you.

Nonsurgical fat reduction

Your body doesn’t have to miss out on the fun! There are minimally invasive procedures that can help sculpt your body as well while offering quick recovery times.

Kybella is an injectable that melts fat, which is great for under the chin, as well as other areas such as the armpit fat and even the abdomen. Emsculpt can give you improved muscle tone in your abdomen and other areas of your body. Minimally invasive fat reduction can be achieved with CoolSculpting, SculpSure and other technologies.

Some of these technologies for your body may not give you very fast results or may require slightly longer recovery time compared to skin care, injectables and other facial treatments. Make sure you get educated to make the right choice for your timeframe.

Your board-certified plastic surgeon will be able to give you all minimally invasive and surgical treatments you need to look your best. Please check out other articles in the ASPS blog for more information about the surgical procedures and minimally invasive treatments that you are most interested in.

The views expressed in this blog are those of the author and do not necessarily reflect the opinions of the American Society of Plastic Surgeons.

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Two types of rhinoplasty explained – cosmetic vs functional

two types of rhinoplasty explained – cosmetic vs functional

When speaking about rhinoplasty, I explain to patients that the single term can refer to a wide range of elements. Nose surgery may involve altering the size and shape of the nostrils, bridge, nasal tip and/or other structures. The goal is harmonizing the shape and proportion of the nose with the entire face.

More broadly, rhinoplasty can be used to describe not only cosmetic procedures designed to impact the look of the nose, but also medical procedures to improve the function of the nose.

Why do patients choose rhinoplasty?

The two surgical focuses are closely linked because the form and function of the nose are intertwined. A visible asymmetry on the outside very likely indicates misaligned structures on the inside. Such irregularities can disrupt and impede the free flow of air, making breathing a more laborious task than it should be. In many cases, correcting the internal problem leads to a corresponding, aesthetically pleasing external shift, as well.

Functional rhinoplasty

Common problems seen in patients seeking functional rhinoplasty include nasal passages that are too narrow and a crooked (or “deviated”) line of cartilage known as the septum. A person’s septum may be misaligned due to its natural development, or it may have been pushed out of alignment due to trauma.

On its own, a procedure for straightening the septum is known as a septoplasty. Positioning the cartilage so that it sits properly vertical, instead of at an angle, can allow air to move more easily through each nostril.

Another common functional problem involves allergies, hormones or sinus infections causing turbinates to become enlarged. Also known as nasal conchae because of their shell-like shape, these structures warm and humidify the air as it moves through the nasal passages. Turbinates are made of bone, blood vessels and other tissue and come in three pairs: two superior, two middle and two inferior. If the inferior turbinates—which are the lowest and largest of the structures—become swollen, they can inhibit nasal airflow on both the right and left side of the nose.

Turbinate reduction can resolve this problem. The procedure involves removing tissue to provide more open space that allows air to pass by.

Cosmetic rhinoplasty

Patients pursuing cosmetic rhinoplasty also frequently cite asymmetry as a problem they want corrected. A nose that tilts, leans or points too far to the left or right can draw unwanted attention, especially when the rest of the features of the face are aligned symmetrically.

Other cosmetic issues nose surgery can address include overly wide nostrils, a nasal tip that is either pinched or bulbous and a pronounced bump or dip on the dorsum. Men and women who simply feel that their nose is “too large” often discover that there is one particular feature that is out of proportion.

Oftentimes, correcting a key area can yield results that make the entire nose appear to better balance with the eyes, mouth, forehead, and other parts of the face—including distance between these elements, their angles relative to each other and more.

What should you expect during your recovery?

No matter their procedural specifics, rhinoplasty patients should expect to wear a splint for approximately a week after their surgery. This will hold the nasal tissues in place and ensure that they properly heal in their new alignments.

Bruising and swelling are also to be expected, lasting for about two weeks. Once the skin returns to its typical color and the swelling goes down, the cosmetic results will be more apparent. Note, however, that the nose can take considerable time to heal, so full resolution may not happen for a matter of months, or perhaps even a year.

Is rhinoplasty right for you?

Rhinoplasty can be a life-changing procedure, and it’s no surprise that rhinoplasty is consistently among the top plastic surgery procedures performed every year. If you think rhinoplasty is right for you, be sure to use the ASPS Plastic Surgeon Match referral service to find a board-certified plastic surgeon in your area.

The views expressed in this blog are those of the author and do not necessarily reflect the opinions of the American Society of Plastic Surgeons.

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Three popular options for male body contouring

three popular options for male body contouring

Time affects everyone. With age, the skin and tissues on the face and body stretch, descend and lose their elasticity. This can adversely affect your facial and body contour. For men, in particular, this shows up on the abdomen, chest and the neck/jaw juncture. As plastic surgeons, it is our job to come up with new, safer and better ways to address our patients’ needs. There have been huge advancements of late in terms of nonsurgical modalities for reducing fat and tightening skin. This 1-2 combination has made it possible to treat many of the male face and body contouring issues without having to resort to surgery. This is a huge plus for men who have less tolerance for downtime.

Sometimes, however, surgery is going to be the best option. Whenever considering any type of aesthetic procedure, it is important that you be assessed in person by a board-certified plastic surgeon. You want to see someone who not only offers the full range of nonsurgical and surgical options, but who also has the experience and training to deliver a safe, natural-looking result. The internet has made patients more aware of the many male face and body contouring options, but a procedure is only effective if it is the right match for your individual anatomy and needs. Bottom line: what worked for your friend may not work for you.

Male body contouring options for treating the abdomen

The abdomen is probably the single greatest area of concern for most men. Many men want to have a taut, flat abdomen with visible abdominal muscles, also known as the “six-pack.” With age, however, some men tend to develop a gut no matter how hard they exercise or how well they eat which can hide that taunt abdomen. The fat on the outside of the abdominal wall—the extra-abdominal fat—is treatable. On the nonsurgical side, the two most popular fat reduction techniques are:

Both work by destroying the fat cells in the treatment area either through cold or heat. Once destroyed, these cells are then eliminated through your body’s own lymphatic and metabolic systems. CoolSculping® and SculpSure® are both fast, effective and versatile. However, they each require multiple treatments, spaced 6-8 weeks apart, in order to deliver optimum results. The goal for each treatment is to reduce the targeted fat by about 20%.

Liposuction, on the other hand, is a more aggressive surgical procedure and can be more effective. Most plastic surgeons agree that liposuction is the gold standard when it comes to male abdomen and flank body contouring. It allows the surgeon to literally re-sculpt your torso. Laser technology can also be used as an adjunct body contouring modality. In the right patient, it can even reveal the 6 pack abs that are covered by the extra-abdominal fat. Liposuction does require downtime, typically about a week, and you will need to wear a compression garment to ensure the best results and skin contour.

Gynecomastia options for a flatter chest

The second most popular area for men when it comes to body contouring is the chest. Gynecomastia is a fullness in the chest caused by an excess in glandular tissue, fat or a combination of the two. Incredibly common, there are a number of different ways to treat gynecomastia. The right procedure is going to depend on the underlying cause. In patients whose fullness is solely the result of too much fat, liposuction is the most common form of treatment. Sculpting and reducing the fat may lead to a trimmer and more masculine chest. Liposuction of the chest can be done safely under local anesthesia with minimal downtime and recovery.

Most men who are afflicted with gynecomastia, however, have excess glandular tissue in addition to fat. The gland must be surgically removed in order to deliver the kind of flat, smooth chest that men desire. There are a few different incision options. The right one is going to depend on the amount of breast tissue that needs to be removed. Although the idea of scars on the chest sounds frightening, ideally, the incision can be camouflaged in the border between the darker skin of the nipple and the lighter skin on the chest. Men who have excess, loose skin in addition to gland and fat might need surgical removal and adjustment of the skin as well.

Aesthetic procedures for a crisp jawline

A crisp jawline is a youthful-looking jawline. Unfortunately, some men aren’t born this way and some lose this definition with age. The area under the chin is a prime spot for excess fat in men. Whether you wear a tie or not, a buildup of fat at the neck/chin juncture can make you feel dumpy and overweight when you are not. Thankfully, this focused area of fat accumulation is treated well with noninvasive body contouring devices such as CoolSculpting® and SculpSure®. Furthermore, there is an injectable, Kybella®, that was specifically designed to decrease the submental fat beneath the chin. In patients with a severe amount of extra fat, liposuction is probably going to be the best option.

Assuming that your skin has enough elasticity or “bounce back,” these can all be stand-alone procedures. However, older men or men who have loose or lax neck skin may need to combine a fat reducing modality with a skin tightening procedure such as ThermiRF. The latter uses radiofrequency energy to heat up the tissue in the treatment area. This creates a controlled injury to the neck skin. The body’s natural response to any injury is to produce more collagen and elastin. As the foundations of youthful-looking skin, more collagen and elastin results in smoother, tighter, more lifted looking skin.

So, if you would like a face or body contour with a bit more tone, schedule a consultation with a board-certified plastic surgeon in your area to discuss which options might be right for you. It’s not just about looking better. Getting rid of pockets of excess fat may make you feel more vital, confident and in charge.

The views expressed in this blog are those of the author and do not necessarily reflect the opinions of the American Society of Plastic Surgeons.

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A new minimally invasive treatment to get you ready for the holidays

minimally invasive procedures to get you ready for the holidays

Now that the holidays are quickly upon us, how do we look great at the holiday party on very short notice? Luckily, there are several new aesthetic options that don’t require surgery or significant downtime.

PDO threads are synthetic absorbable surgical sutures that are used to enhance the appearance of the area treated. Although most commonly used in the face, PDO threads have also been successfully used in the extremities and the abdomen. PDO stands for polydioxanone, a material that induces collagen production around the thread. The thread can increase collagen production by up to 100% in the area treated.

How do PDO threads work?

When barbed threads are used in the face, they can lift the skin in the cheeks, jowls and marionette lines. The contour of the face is improved while, at the same time, stimulating long-term collagen production. In addition, PDO threads can be used to give lip fullness as well as reduce wrinkles in the perioral area.

The procedure takes less than one hour and is done under local anesthesia. Bruising and swelling can occur, but usually, patients can apply makeup and return to work the next day. If desired, thread lifts can be added to enhance surgical procedures such as a neck lift or facelift. They can also be combined with dermal fillers or neurotoxin treatments.

What results can you expect PDO threads?

For those patients do not want to undergo surgery, PDO threads offer an excellent alternative. The results last 12-24 months, but they are instantaneous and require minimal downtime. The best candidates for thread lifts are those who have early signs of aging. Patients with heavy tissues and advanced aging signs are probably better off with more traditional facial plastic surgery.

As with any aesthetic procedure, proper patient selection is key. If the patient is well informed and has appropriate expectations, PDO threads can yield a quick, natural-appearing rejuvenation. For the plastic surgeon, PDO threads represent another arrow in the ever-expanding quiver of choices that we can offer our patients.

So add a little Botox, some filler and a PDO lift and you can be at the company holiday party with no sign of surgery and without having missed a single day of work!

The views expressed in this blog are those of the author and do not necessarily reflect the opinions of the American Society of Plastic Surgeons.

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What’s so special about Retin-A?

what's so special about retin-A

Retin-A, or Tretinoin, is a form of vitamin A that was developed at the University of Pennsylvania in the 1960s. One of the most successful patents of all time, it revolutionized topical skin care and still has great utility today.

To understand how Retin-A works, it helps to understand the effects of aging on the skin. The most superficial cells—the keratinocytes of the epidermis—tend to become more adhesive and hang around longer. This leaves the skin looking dryer and rougher. The epidermal cells at the base also do not replicate as quickly, so the lifespan of these cells in the outer layer is much longer—and it shows. The pigmentation can become irregular and mottled because of this.

The deeper layer of cells, called the dermis, and the collagen bundles become thinner and disordered, allowing for creases and fine wrinkles to more easily show the muscular activity from below.

How does Retin-A work?

Retin-A is a topical medicine available by prescription only that is applied sparingly to the facial skin, sparing the eyelids and the corners of the nose and lips. It works at the cellular level and takes several months to see the full effect. In many ways, Retin-A can be thought of as reversing the outwards signs of aging on the skin.

The earliest effect of Retin-A is that the outer layer of keratinocytes start shedding off, leaving the skin fresher, smoother and more evenly pigmented. The next effect seen is that the epidermal cells start to replicate faster causing the skin to look and feel softer, more robust and healthier. Finally, the collagen bundles in the dermis will thicken and organize, causing the appearance of fine lines and wrinkles to lessen with time.

Retin-A improves the cosmetic appearance of the skin, but it also helps treat some functional problems of the skin such as acne and precancerous conditions, such as actinic keratoses.

How is Retin-A used for beauty treatments?

Typical treatment regimens include a period of tapering up. The topical product is applied sparingly 2-3 nights per week for several weeks and then the frequency is gradually increased until a nightly regimen is attained. A cream or gel delivery system is chosen based on the skin’s underlying dry or oily predisposition and the concentration can be increased over time.

Common side effects are raw itchy burning skin, generally from more aggressive application in the early phase of exposure. Often taking a break for a few days before continuing the medication at a slower ramp-up will remedy this. Sensitive areas like the corners of the nose, eyelids, lips and corners of the lips should not be treated. Patients should avoid exposure to the sun following Retin-A treatments. The use during pregnancy should also be avoided.

Pretreatment with Retin-A is extremely helpful prior to moderate to deep chemical peel, laser treatments, dermabrasion or facelifting to hasten healing and help prevent scarring or dyspigmentation. Retin-A is certainly a useful addition to any beauty regimen.

The views expressed in this blog are those of the author and do not necessarily reflect the opinions of the American Society of Plastic Surgeons.

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How long does Botox last?

how long does Botox last?

Let’s start with what Botox is. Botox is the brand name for Onobotulinumtoxin A, a neurotoxin derived from Clostridium botulinum. There are currently four different types that are FDA-approved for cosmetic facial wrinkles. These include Botox, Xeomin, Dysport and now Jeuveau.

They all work by blocking a signal from the nerve to the targeted muscle that prevents it from contracting. By preventing the contraction of these specific muscles, there is less action or pull on the skin and a decrease in the formation of wrinkles. While all of these products have the same end result, they differ slightly in their onset, duration of action and discomfort.

When to use each product is dependent on several things. Sometimes, it is the surgeon’s or injector’s preference. In other instances, a patient may have had experience with different products and have found that one works better than the other in them personally. In either case, all of these products are safe and effective in the right hands.

What to expect during your procedure

Finally, the real question. Oftentimes, at the time of your injection, your injector will discuss with you your goals and, after an examination, will be able to assess if those goals can be achieved with the use of neurotoxin. If it can, it’s your lucky day!

Your face will be cleansed and the areas that are to be injected, possibly marked with a removable eyeliner/marker. You might have a numbing cream applied or be given ice packs to help with any discomfort. Once you are ready, the injections will be performed in various areas to target the desired muscles.

You might have a few small bumps in the skin at the actual injection site but these will be gone by the time you leave the office. You might also have some mild bruising which will resolve in 24-48 hours. Finally, you will be given instructions on what to do and what not to do in the next 24 hours. This is can vary from injector to injector.

Onset

Neurotoxins generally take effect in 3-5 days but it is common to not see your full and final results for 7-10 days. I, personally, always tell my patients to wait a full 2 weeks after their Botox injection and, at that point if they need a touch-up, we will take care of it. It takes this long because it takes time for the toxin to block off those nerve impulses to the muscles. It is not immediate.

Duration

Well, don’t we wish Botox lasted forever? Unfortunately, it doesn’t. Eventually, the action of the neurotoxin will wear off and the nerves will again be able to send those signals to the muscles to start working or contracting. In general, Botox lasts 3-4 months.

There will certainly be patients in which in lasts longer, in that 4-6 month range, or shorter, in that 2-month range. It is also common for first-timers to notice that it may not last as long initially but may last longer after the second treatment. Everyone has a unique experience and results may vary.

Hopefully, this helps answer any questions you have about Botox or other neurotoxins. For any further questions, consult with your local board-certified plastic surgeon or use the ASPS Ask A Surgeon tool.

The views expressed in this blog are those of the author and do not necessarily reflect the opinions of the American Society of Plastic Surgeons.

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Five common questions everyone has about getting a facelift

five common facelift questions

With so many facial products and nonsurgical treatment options available that address signs of aging, is a facelift still something people consider? The answer is that a surgical facelift remains an excellent option for many women and men who want better facial definition, smoother skin and an overall younger appearance. While numerous other options exist, facelifts are still the most effective way to lift sagging facial tissue and eliminate sagging neck skin.

To help you better understand the procedure and decide if it is right for you, here are some answers to a few of the top questions people have.

How do I know if I need a facelift?

When your daily regimen of creams and serums, or even nonsurgical treatment options, don’t seem to make a difference anymore, it may be time to consider a facelift procedure. If you have sagging skin that easily pulls away from the face and neck or hangs loosely, a facelift is the only treatment option that can help. The facelift procedure removes this extra skin, creating a firm, youthful appearance.

What happens during the surgery?

Several different techniques may be used during a facelift procedure, depending on the cosmetic concern your surgeon is correcting. After anesthesia is administered, incisions for a facelift are usually placed in the hairline around the temple and work down to the lower scalp. During this procedure, the surgeon will sculpt or remove fat, reposition underlying tissue and lift facial muscles. A small incision under the chin may be needed to treat an aging neck. Once complete, the incisions are closed with sutures or skin adhesives.

What about recovery and scarring?

After your facelift procedure, you can expect your lower face and neck to feel sore and tight for the first few days. Pain medications are usually prescribed and can help ease discomfort. Taking a couple weeks off from work is advised to allow yourself time to heal. You may be advised to avoid strenuous exercise for at least three weeks. While individual healing times vary, within about 10 days, the swelling and bruising should be minimal. Makeup is usually enough to cover any signs of surgery until your face heals completely.

Because the incisions follow your hairline, facelift scars typically aren’t noticeable. Even when a chin incision is necessary, it should be placed to follow the natural creases in your chin, hiding the scar.

When will I see real results?

You may see changes to your facial appearance immediately after the procedure, though you will experience bruising and swelling for the first 2 weeks. After that, any additional bruising can be covered with makeup. Your face may not yet feel normal and can take anywhere from 2 to 3 months to completely heal. Your face should appear much more youthful and toned and many patients are often able to take as much as 10 years off their appearance.

How much is the procedure?

The cost for a facelift procedure varies based on a variety of factors including the amount of correction needed, the surgeon’s experience and the area where you live. According to the American Society of Plastic Surgeons, the average cost of a facelift nationwide is $7,655. Keep in mind that this estimated cost does not include anesthesia or operating room expenses.

Next steps on your facelift journey

If you think facelift surgery is right for you and you’re ready to meet with a board-certified plastic surgeon for a consultation, be sure to use the ASPS Plastic Surgeon Match referral service to find an ASPS member surgeon in your area.

The views expressed in this blog are those of the author and do not necessarily reflect the opinions of the American Society of Plastic Surgeons.

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