Anti-Wrinkle Injections: The Facts

Anti-wrinkle injections are currently the most common medical cosmetic treatment.  There have been  17 million injections that have been safely administered for cosmetic purposes alone since 2002.  It is currently approved for treatment of glabella wrinkles, which are the frown lines between the eyebrows.  Any other treatments are considered “off-label” (a common and legal practice in which a drug is used for a purpose other than the officially approved one).

Here  are  some  other  interesting  facts  you  should  be  aware  of:

  • Clostridium Botulinum (the bacteria that causes food poisoning) was first identified at the University of Gent, Belgium, in  1895.
  • Anti-wrinkle injections consist of Botulinum toxin type A, which was isolated in the purified form by Dr. Herman Sommer at the University of California in the  1920s.
  • Botulinum toxin type A stops the release of certain chemicals at the junction between a nerve and a  muscle, so the message for the muscle to  ”work” is blocked and therefore relaxes.  Its anti-wrinkle properties were discovered in the 1980s  by  Dr.  Jean  Carruthers  (an ophthalmologist) and her husband  Arthur  (a  dermatologist) when patients being treated for crossed eyes and facial spasms told their doctors that their lines and wrinkles had vanished since starting the injections.
  • Anti-wrinkle injections are approved in more than 75 countries for 20 different neurological indications and approved for cosmetic use in more than 40  countries.
  • In the  20-year history of using the drug for cosmetic treatments, there is no anecdotal evidence of any long-term problems because any muscle weakness from the injections is reversible because Botulinum toxin type A ’s action is temporary.
  • Botulinum toxin type A has been used in other conditions such as migraines, excessive sweating,  incontinence, hemorrhoids and has even been used on patients with gallstones.
  • The cosmetic formula on uses a much lower dose of the toxin than the one used to treat major muscle spasms.
  • Anti-wrinkle injections are not a panacea for every facial wrinkle.  Those caused by other mechanisms such as hereditary,  smoking, sun exposure, and the effects of gravity,  do not respond adequately.  Nor are anti-wrinkle injections particularly effective for wrinkles around the mouth.  Other treatments (such as Retin-A, chemical peels, collagen or fat injections, laser therapy, or facelifts) may help for people who wish to minimize these types of wrinkles.

A  U.S. consumer advocacy group called Public Citizen has recently asked the Food and Drug  Administration  (FDA) to reconsider the safety of anti-wrinkle treatments.  However, my main issue with them is that they have grouped together adverse events from both the medical and cosmetic uses of the drug.  They pointed to  180 cases of serious complications like pneumonia and difficulty breathing or swallowing, which included 16  deaths  (collected from  9 full years of data).  Earlier in 2005,  The Centers for Disease Control and Prevention reviewed  1,437  adverse reports:  406 after medical use of the toxin  (217 of them were serious effects)  and  1,031 after cosmetic use  (36 of them serious).  The proportion of serious reports was  33-fold higher for patients treated for medical problems than for those receiving cosmetic treatments and the worst disasters have occurred when unqualified practitioners administered the drug.  The FDA has also confirmed that there has never been a reported death where a causal link to the cosmetic use of anti-wrinkle injection was established.

Don’t forget that many cancer medications are derived from substances that in other contexts would be considered dangerous.  And many other drugs that are licensed for a  particular condition are used  “off label” to treat other problems.  Remember, all drugs have unwanted side-effects, so that with more people using anti-wrinkle injections, the list of unwanted effects may be growing.

Earlier this year,  the Food and Drug  Administration  (FDA) which reviews the continuing safety of anti-wrinkle injections, notified the public about reports of their serious side-effects.  Most of these,  however, resulted from medical, not cosmetic uses of the toxin.  Medical treatments typically require much larger doses, and many of the patients have other health problems that increase their risk.  For e.g. to treat the furrows between the brows,  a typical dose consists of 20-35  i.u.’s  (intramuscular units) compared to over  200 for neuromuscular disorders.  The reactions included respiratory failure (which sometimes was fatal) in a range of doses and use, many of them “off-label” e.g. limb spasticity associated with cerebral palsy in children.

So,  my  advice  to  patients  and  clients  seeking  anti-wrinkle  injections  would  be:

  • Choose your doctor or nurse injector carefully.  They should be both experienced and competent and make you feel safe and at ease.
  • Injectables should be performed in an approved medical office or medical spa.
  • Ques on the authenticity of the injectable.  Ask to be shown the brand packaging.
  • Pay close attention to the potential complications which should be thoroughly discussed during the informed consent process.

Thanks for reading!

Dr. Tim  –  Sydney  Cosmetic  Plastic  Surgeon

www.cosmeticculture.com.au
www.drtim.com.au

Teenage Cosmetic Surgery: Why So Much Pressure?

 

There has been a storm brewing for some me now regarding teenage cosmetic surgery.  A concoction made up of quick fixes,  a society obsessed with beauty, and the commercialisation and overexposure of cosmetic surgery. This has all lent themselves to the growth of cosmetic surgery for  Generation  X and younger.  This has been further compounded by the increasing number of medical specialists entering the cosmetic arena.

My worry is that this Generation X and their successors wanting teenage cosmetic surgery may become an abused marketplace.  It would appear that they have it a little easier, in the sense that, they have parents or relatives who have had cosmetic surgery and are approving of it, in an economy that has been both buoyant and robust for some time now.  This takes away from the fact, that teenage cosmetic surgery needs much more scrutiny because it can play on people’s insecurities and promises of an instantly better life.

Most plastic surgeons I believe are responsible individuals with a conscience who try and counsel teenagers, usually in front of their parents, of the risks, benefits, and outcomes of procedures, as well as whether they are appropriate or not. They try very hard to show that TV programs like Extreme Makeover,  Dr.  90210  and  The Swan trivialise and glamourise cosmetic surgery and that glossy magazines like Teen Vogue or Teen Cosmo display airbrushed photos of models and celebrities that are in reality unachievable.

Now teenagers who want to have cosmetic surgery usually have different motivations and goals than adults.  They too have cosmetic surgery to improve physical characteristics they feel are awkward or flawed,  that if left uncorrected, may affect them well into adulthood.  Teens tend to have cosmetic surgery to fit in with peers, to look similar.  Adults tend to have cosmetic surgery to stand out from others.  Teenagers frequently gain self-esteem and confidence when their physical problems are corrected.  In fact, successful teenage cosmetic surgery may reverse the social withdrawal that generally accompanies teenagers who feel different.  Not every teenager seeking cosmetic surgery is well suited for an operation.  Teenagers must demonstrate emotional maturity and an understanding of the limitations of cosmetic surgery.

I would caution teenagers and parents to keep in mind that cosmetic surgery is real surgery, with great benefits, but also carries some risks. Teenagers should have realistic expectations about cosmetic surgery and what it can do for them. In addition, certain milestones in growth and physical maturity must be achieved before undergoing cosmetic surgery. The most rewarding outcomes are expected when the following exist:

  1. The teenager initiates the request.
    The young person must appreciate both the benefits and limitations of cosmetic surgery, avoiding unrealistic expectations about life changes that will occur as a result of the procedure.
  2. The teenager has realistic goals.
    While parental support isn’t lessened at all, the teenager’s own desire for cosmetic surgery must be clearly expressed and repeated over a period of time.
  3.  The teenager has sufficient maturity.
    Teenagers must be able to tolerate the discomfort and temporary disfigurement of a surgical procedure.  Cosmetic surgery is not recommended for teens who are prone to mood swings or erratic behavior, who are abusing drugs and/ or alcohol, or who are being treated for clinical depression or other mental illness.

Some of the commonest teenage cosmetic surgery procedures include:

  1. Rhinoplasty (nose reshaping)

Cosmetic surgery may be performed on the nose to straighten the bridge, remove an unsightly hump, reshape the point or open breathing passages. Ordinarily, this is not performed until the nose reaches its adult size –  about age 15 or 16 in girls and a year later in boys. The procedure accounted for nearly 50 percent of all cosmetic surgical procedures performed on this age group.

2.Otoplasty (ear surgery)

Surgical correction of protruding ears, in which the ears are pinned back, may be performed any time after the age of five. Otoplasty made up 11 percent of all cosmetic surgical procedures performed on this age group.

3. Correction of Breast Asymmetry

When one breast grows to a much larger size than the other, an operation may correct the difference by reducing the larger breast, augmenting the smaller, or both. Many teenagers who want breast augmentation tend to have one breast that is larger than the other – sometimes a full cup size or more in difference. This condition is called breast asymmetry. Using a breast implant in the smaller breast allows the patient to have breasts of the same size. Although waiting may prolong the physical awkwardness, it is advisable to delay surgery until breast growth ceases in order to achieve the best result.

4. Breast Augmentation

Breast implants can be used for breast augmentation in women 18-years or older and for breast reconstruction.

Many teenagers who want breast augmentation to have one breast that is larger than the other -sometimes a full cup size or more in difference. This condition is called breast asymmetry. Using a breast implant in the smaller breast allows the patient to have breasts of the same size. Although waiting may prolong the physical awkwardness, it is advisable to delay surgery until breast growth ceases in order to achieve the best result.

5. Breast Reduction

Surgical reduction of very large breasts can overcome both physical and psychological burdens for a teenage girl.

In fact, many teenagers suffer ongoing back pain due to overly large breasts. Although waiting may prolong the psychological awkwardness, it is advisable to delay surgery until breast growth ceases in order to achieve the best result.

6. Acne and Acne Scar Treatment

Acne eruptions may be controlled by the proper use of modern prescription drugs. In addition to supervising the use of these medications, plastic surgeons may improve acne scars by smoothing or “refinishing” the skin with a laser or with a fine sanding technique called microdermabrasion. Other treatments for acne related skin problems include laser skin resurfacing, dermabrasion, and chemical peels.

7. Male Breast Reduction (Gynaecomastia)

Teenage boys with large breasts, known as gynecomastia, are often eager to undergo plastic surgery. Surgical correction can be accomplished in a variety of ways including liposuction and/or surgical excision of the breast tissue.

As a plastic surgeon, I am an advocate for the right teenage cosmetic surgery, at the right time, and for the right reason. Things like correction of prominent ears, breast reduction in adolescent boys or breast reconstruction in young girls with an underdeveloped breast can truly advance the person’s quality of life. It is our responsibility as plastic surgeons to guide teenagers (and their parents) in the right direction and to educate them that cosmetic surgery is not a panacea for the everyday pressures that teenagers’ face. Cosmetic surgery can make you more attractive but not necessarily happier!

Question: What do you think is the commonest reason teenagers want cosmetic surgery? You can leave a comment below.

How Do You Repair Torn Earlobes?

The earlobes are the lowest part of the ears made of skin and a small amount of fatty tissue in between. There are large variations in size, form, and shape. The earlobes serve women (and men) as popular locations for placing jewellery. Often, the earlobes are pierced to fit various forms of ear ornaments ranging from studs to earrings which can occasionally set them up for trouble.

Excessive weight or trauma can easily overcome the strength of the earlobe tissues leading to a tear, which if complete, results in a split ear. Some people with rather thin earlobes who favour wearing heavy earrings, experience a gradual elongation of the ear-piercing tract such that it becomes slit-like and often too large. Another problem is that the earlobes can be torn by accidental trauma. This split may be unattractive and renders the earlobe unusable for most jewellery. Sometimes, clip-on earrings can still be fitted and are used to camouflage the earlobe tear.

The repair of torn earlobes is relatively simple. The procedure is routinely performed in the office under local anaesthesia with an optional sedative. After planning and marking, a small amount of lignocaine numbing solution is deposited. I favour a three-layer repair done under loupe magnification. But it is very important to remove the damaged ear-piercing tract or to trim the edges of the split if the earlobe has been torn through completely.

Then the three-layer closure consists of closing the outer layer of skin, the fatty tissue between the two layers of the skin and finally the skin in the back of the earlobe. Typically, the surgeon must take great pains to avoid any notching at the bottom of the earlobe. The fine sutures on the skin are usually removed within 7 days. Small amounts of antibiotic ointment are applied at home for a few days ensuring cleanliness. The healed earlobe has usually a barely visible pencil-fine straight or zigzag scar line.

People often ask if the ears can be pierced again. They can but typically you should wait three months after the earlobe has been repaired. Preferably piercing should not be done within the scar, as this can stretch and inevitably result in another clot.

Thanks for reading!

Dr. Tim – Sydney Cosmetic Plastic Surgeon

www.cosmeticculture.com.au
www.drtim.com.au

Facial Rejuvenation: The Five (5) S’s that causes facial skin damage

Often, I’m asked by my Facial Rejuvenation patients about how long their face lift may last. I’m reminded of the French surgeon Dr Vladimir Mitz, a pioneer in anatomy regarding facelift surgery, who told me once he had a crystal ball on his desk to answer such a question! At the time, I hadn’t appreciated how profound this idea was. It makes a lot of sense to me now. Why?

There are several factors to take into account when thinking about treating patients for facial rejuvenation. I call these “the 5 S’s” and they affect your skin and thus the face.  These are:

  1. Stress
  2. Sun
  3. Smoking
  4. Sleepless nights
  5. Sugars

Let’s just take stress’s terrible toll on the skin:

  1. Wrinkles: tensing and tightening facial muscles squeezes and pinches the overlying skin, creating wrinkles and lines.
  2. Acne: hormone receptors connected to the oil glands are triggered by stress hormones, so once they’re stimulated, the gland increases oil production, causing pimples and breakouts.
  3. Hair loss: normally, hair follicles are small and resting, or active and growing, but stress shocks the system, throwing the cycle into chaos and causing follicles to sleep longer rather than produce new hair. Once they wake up, the old hair falls out
  4. Grinding teeth: jaw tension will create lines and wrinkles as skin is pinched and collagen is broken down.
  5. Increased free radicals: stress causes blood vessels to clamp down, causing a shunting of blood away from the skin as blood focuses on internal organs.

Lack of blood leaves skin vulnerable to assault from the sun, cigarette smoke and other outside pollutants that create free radicals. As an example of what stress is capable of, we have all seen people who have lost their loved ones and 6-12 months down the track they’ve seemed to have aged 5-10 years; their skin is more wrinkled, dry and sallow looking. Imagine if you throw in the other factors like sun exposure and smoking and you can see how they can affect the longevity of a face lift. That’s why it’s like looking into a crystal ball. I say to patients that a face lift usually lasts 7-10 years if you are lucky and maintain it with regular microdermabrasion, skin peels and laser skin tightening.

Things that you can do for facial rejuvenation to improve the health of your skin is to:

  1. Use regular sunscreen to protect your skin from free radicals from the outside world.
  2. Use antioxidants either applied topically or consumed orally such as vitamins A, C, E, lycopene, CoQ10, idebenone, green tea and grape seed extract.
  3. Take Vitamin B to stimulate hair growth.
  4. Relax. Calming your central nervous system and mind to give stress hormones a chance to switch off is a good thing. Try meditation, some quiet time or exercise.
  5. Anti-wrinkle injections. These injections not only make you feel better when you look your best, but medically they help muscles relax. There is a biofeedback between muscles and the brain, so if muscles aren’t tense, the brain interprets the quietness as calm and lets its guard down.

Question:  What do you do for facial rejuvenation to prevent facial aging? You can leave a comment below.

7 things you should know about Rhinoplasty

1)  Cosmetic Plastic Surgeons can sculpt your nose and make it look better, but they have to work with what they are presented.  In other words, you need to reconcile desires with reality.  What do you want and what will my nose allow me to have?  It’s fine to provide your cosmetic plastic surgeon with photos of noses you like, but keep in mind that you may not always get what you want but actually what you need and what is in keeping with your framework.

2)  Perfect noses don’t exist after rhinoplasty.  It’s likely that you’ll still find flaws, possibly any bump on the nasal bridge or an uneven nostril.  Try to keep in mind that you’re going for improvement, not perfection.

3)  You may have “raccoon eyes” and look a bit like an Egyptian mummy for the first few days post-operatively.  If the nose needs to be broken, expect a splint over the bridge of your nose, possible packing in your nostrils and a pad taped under your nose to catch drainage.

4)  Don’t wear glasses/sunglasses for the first six weeks post-operatively, so that the nasal bridge can heal correctly.

5)  You may find this surprising but rhinoplasty is usually painless, especially if you stay on top of your medications.  You will, however, be tired and possibly nauseas.  Your breathing may have been improved if a deviated septum was fixed at the same me.  Sometimes, breathing may be made significantly worse after the procedure (this may result in a very nasal voice for a few weeks to months) but generally improves once the swelling subsides.

6)  What most people find amazing who have had a rhinoplasty is how many family members and friends won’t notice you’ve had anything done despite having your nose reshaped and many weeks recovering.

7)  Right after your new nose is revealed, you don’t look exactly like yourself and that can feel strange and you may feel a sense of disappointment.  You need to give things me to settle down: usually 70 % of the result is seen at 3 months and typically you have to wait 12 months for the final result.

Thanks for reading!

 

Dr Tim – Sydney Cosmetic Plastic Surgeon

www.cosmeticculture.com.au
www.drtim.com.au

Laser Hair Removal Mythconceptions

There is no such thing as a single “best” laser for hair removal on all patients.  The best laser for laser hair removal for each person really depends on his or her skin colour. Thus, multiple lasers exist for hair removal. Different laser types, which emit distinct wavelengths of light, are better for treating different skin types. There are a number of manufacturers that make these laser types:

  • Alexandrite lasers. These emit laser light at 755 nm. These lasers work best on lighter skin. In my opinion,  it has been the most impressive laser for hair removal for light to olive skin types.
  • Diode Lasers.  These emit light at a wavelength of 810  nm.  Lighter skin types do well with this type of laser, as do some darker skin types.
  • Nd: YAG lasers.  These emit a 1064 nm wavelength.  This laser is best for darker skin types, as the higher wavelength reaches deeper into the skin.  This helps to avoid superficial skin melanin,  which pigments our skin.
  • IPL or  Intense  Pulsed  Light. It has been used for hair removal.  Lasers emit light at one wavelength (like laser pointers in PowerPoint presentations).  IPL machines produce a range of wavelengths  (like the cone of light from a torch one sees in cartoons) and are not lasers.  So,  there  is  no  such  thing  as  an  “IPL  laser”  or  “IPL laser  hair  removal”-  it’s  a  marketing  ploy  for  businesses  that  have  IPL  machines  and  not  hair  removal  lasers (the  only  exception  to  the  rule  are  the  few  machines  out  there  that  have  both  lasers  and  IPL  machines  in them).  Several studies have shown that  IPL is not as effective as dedicated hair removal lasers, and carry a higher risk of burns, blisters, and changes in pigment.

In my experience,  the Alexandrite laser is the most effective laser for removing hair on the lighter skin, whereas the Nd: YAG is the safest and best laser for more darkly pigmented skin.  Remember,  every laser  has  a  “target.”  For hair removal lasers, the goal is to selectively target the pigment (in other words colour) which in this case is called melanin found in hair follicles.  Melanin is the reason why we have black or brown hair or shades in between.  The hair follicles are living cells which make hair below the surface of the skin.  When the melanin is selectively heated, this destroys the hair follicle cells.  The lighter the hair, the less melanin the hair follicles will have in them.  As a result, hair that is blonde, white or grey does not improve with laser hair removal.  In my practice,  I have actually seen some patients notice a decrease in lighter hairs,  but it ’s the exception and not the rule.

Melanin is also present in skin and is the cause for dark skin and suntans.  It is the same target that the hair removal laser is trying to reach in hair follicles.  Hair removal lasers may target the melanin in the skin as well as in the hair follicles which sometimes results in burns,  blisters, and change in skin pigmentation.  As a result,  lower settings and longer laser pulse times must be used for darker skin to avoid damage.  As a consequence, more overall treatment sessions will usually be necessary.

Remember, laser hair removal is a medical procedure and you should always consult with a doctor who has extensive experience in lasers and laser hair removal.  This will maximize your chances of a great result.

Thanks for reading!

Dr.  Tim  –  Sydney  Cosmetic  Plastic  Surgeon

www.cosmeticculture.com.au
www.drtim.com.au

Non-Surgical Nose Job – Does It Work?

A non-surgical rhinoplasty (nose job) involves injection of safe and effective filler materials (typically hyaluronic acids, tiny calcium granules or fat injections) to alter the shape of the nose.  Non-surgical rhinoplasty can only be used to alter the shape by adding structure to the nose and cannot remove any structure from the nose.  It is always an “additive” procedure because placing more volume in the nose makes it larger (remember very few primary rhinoplasties are performed to make the nose larger).

Indications

Patients suitable for non-surgical rhinoplasty include:
  1. Noses with small humps or bumps
  2. Asian or primary rhinoplasty patients requiring dorsal augmentation only
  3. Noses that have had prior surgery and are overly scooped (“ski slope noses”) or have small contour deformities/irregularities
  4. Saddle nose deformity (“Boxer’s nose”), which is caused by a collapse of nasal structures typically caused by fracture
  5. Polly beak (supratip) deformity
  6. Nose with a retracted columella (a sharp and deep angle between the upper lip and the nose)
  7. Noses with slight asymmetry
  8. Patients that are too young to operate on

Contra-indications

Non-surgical rhinoplasty typically cannot help with the following types of noses:
  1. Noses with large humps
  2. Large noses
  3. Noses with significant asymmetry
  4. Noses that need a reduction

The most common filler material used for non-surgical rhinoplasty are hyaluronic acid fillers as they can be injected and molded into shape, yet firm enough to maintain their shape after injection. They are very safe and well tolerated by the body. It is very important that the filler material is injected deeply, just above the bone or cartilage of the nose.

Non-surgical rhinoplasty is a quick and easy alternative for those who want to improve certain features of their nose as indicated above.  Non-surgical rhinoplasty takes less than 5-10 minutes to perform and has minimal discomfort and minimal recovery associated with it.  Results typically last up to one year.  The good thing about a non-surgical rhinoplasty is that it is not permanent and if you don’t like your nose enlarged, the fillers will be resorbed in a several month period and it will return to its original size.  Fat grating may offer a more permanent solution short of surgery.  Non-surgical rhinoplasty should ideally be performed by a surgeon who is also experienced in surgical rhinoplasty.

Thanks for reading!

Dr Tim – Sydney Cosmetic Plastic Surgeon

www.cosmeticculture.com.au
www.drtim.com.au

How Can a Brow Lift Benefit You?

Appearance is everything these days and unfortunately, the ageing process is something we all must inevitably suffer whether we like it or not. There is still hope, however, for those of us who suffer from droopy eyebrows, sagging skin or deep furrows on the forehead, in the form of a brow lift.

How can a brow lift benefit you.jpg.001

If you’ve had enough of those tired and weary eyes staring back at you in the mirror each morning, a brow lift is a simple procedure that can turn back the years and restore the youthful vigour you once possessed. It’s common knowledge that when you look great, you feel great and your plastic surgeon can offer you two different brow lift techniques to reinvigorate your face.

 

Brow Lift Benefits

A brow lift has many clear benefits for patients choosing this procedure. Apart from improving your overall facial appearance, making you look more awake and less stressed, this procedure will give you an immediate confidence boost to aid you in social and work settings. When this procedure is carried out by a skilled and experienced plastic surgeon, the benefits are increased and you’ll see an improvement in regards to:

  1. Brow height, meaning you appear more alert and vital.
  2. The frown lines between the eyebrows which will lessen with the lifting of the forehead.
  3. Sagging brows which will be re-positioned to reduce the severity of the drooping over the eyelids.
  4. Forehead and nose-bridge creases. These will be reduced as the forehead is lifted.
  5. Shape of brows for women. A brow lift can give women a more aesthetically pleasing arched brow shape.
  6. Tired or irritated appearance, which will make you look more approachable and friendly.

Brow Lift Procedures

There are generally two types of brow lift procedures: The traditional brow lift and the minimal incision brow lift. The type of brow lift procedure you choose depends on the severity of your symptoms.

Traditional Brow lift

The traditional brow lift is generally more suited to patients with excess skin hanging over the upper eyelids, making your brows droop and giving you an unfriendly, angry appearance. Also known as a “temporal brow lift,” this procedure is for patients who wish to raise the outer 2/3 of the brow line. The  brow line can be raised by making a 4cm incision in the temporal region of the scalp, before removing excess skin from the scalp and lifting the brow line to give you a friendly and bright eyed appearance. The advantages of the traditional brow lift are:

  1. The forehead or brow can be lifted higher for more severe cases.
  2. The skin is more easily mobilised.

Minimal Brow Lift

Aside from the obvious benefit of reduced and inconspicuous scarring, the minimal brow lift also minimises the loss of sensation around the site of the incisions. In general, the minimal brow lift is considered more suited to younger patients as this procedure does not involve the removal of excess skin. The incisions are also much smaller than those in the traditional brow lift and are skilfully concealed within the hairline. Whilst the traditional brow lift is rarely used today due to the extensiveness of the incisions, the minimal brow lift is becoming more popular because of the following advantages:

  1. Less visible scarring
  2. Less elevation of the hairline
  3. Less numbness around the incision site
  4. Minimal hair loss
  5. Less invasive
  6. Shorter recovery times
  7. Very little bleeding

Are You a Brow Lift Candidate?

If you are fed up of looking tired and stressed out, and friends have commented on how much older you look these days, it may be the right time to opt for a brow lift. On occasion, low brows are hereditary and because of this, plastic surgeons carry out this procedure on patients younger than 30 years-old.

Recovery Time for Brow Lift Surgery

In the early stages after surgery, you may experience some mild discomfort but nothing that cannot be easily allayed with mild pain medication for up to several days after surgery. Day three is usually when bruising and swelling is at its worst and within two weeks you should be able to fully appreciate the results of the procedure.

Are there Any Risks Involved?

The risks for the brow lift procedure are minimal at worst. You may experience some bleeding or infection and in very rare cases, nerve damage or hair changes but with a skilled and trusted plastic surgeon, the risks are negligible.

If you’ve had enough of looking overworked and unapproachable, it might be time for you to seek out a professional plastic surgeon to carry out a brow lift procedure and restore your youthful gaze.

Question: What is the most annoying feature of having sagging brows? You can leave a comment below.

Eyelid surgery for a more youthful look

Eyelid surgery is an operation that can dramatically improve a patient’s appearance within a relatively short recovery time. Droopy eyelids is one of the major reasons why some people often consider eyelid surgery (blepharoplasty) to get rid of excess eyelid skin for a youthful appearance. In other cases, eyelid surgery helps in improving ones vision by offering a field of view that is less obstructed after the removal of excess skin.

Eyelid surgery for a more youthful look.jpg.001

How is eyelid surgery performed?

Eyelid surgery can be performed on your upper eyelids, lower eyelids or both. The plastic surgeon will carry out pre-operative evaluation on factors such as your facial muscles around the eyes, the symmetry or droopiness of your eyebrows and underlying bone structure. After the evaluation your plastic surgeon will be able to determine the amount of skin and/or fat to get rid of. Some points to consider:

  • your plastic surgeon will make accurate markings to show where the excess tissues will be removed on your lower and upper eyelids.
  • On your upper eyelid, they will make a surgical slit concealed in the natural fold of the upper eyelid.
  • In the lower eyelid, the surgical slit will be concealed below your lower eyelashes. When unwanted fat only is being removed, the slit can be made inside the lower eyelid which is referred to as a transconjunctival incision. Laser resurfacing may at times be used together with this method so as to make the lower eyelid skin tighter.
  • The plastic surgeon will also get rid of excess tissue through these slits.
  • At times, fat may need to be redistributed in the lower lids to completely remove bulges or puffiness. Other changes may be made so as to correct special problems such as muscle laxity.
  • The scars are generally inconspicuous after healing.
  • For patients who have dry eyes, very little amounts of tissue are removed to avoid exposing more of the eye to the air which may worsen the symptoms.

When to consider eyelid surgery

  1. If you have too much skin hanging or covering the upper eyelids natural folds.
  2. If loose skin hangs down from the upper eyelids over the eyelashes.
  3. If the under of your eyes has deep grooves and bulges.
  4. If both your upper and lower eyelids look puffy, making your eyes appear aged and tired.

Many people who consider blepharoplasty also consider facelift, wrinkle smoothers, brow lift and dermal fillers for a complete facial rejuvenation look.

What will my eyelid scars look like?

  1. Upper eyelid surgery: The plastic surgeon will mark the natural lines and creases of the lids and keep the incisions as concealed as possible along the natural folds. Thin sutures will be used in closing up the incisions hence making the scars visibility minimal.
  2. Lower eyelid surgery: In the traditional blepharoplasty, the doctor will make the slit in a hidden side along the lash line and smile creases of the lower lid. In the transconjunctival approach, the doctor amends the eyelid puffiness that results due to excess fat by making a cut inside the lower eyelid. This technique doesn’t need an external slit but it cannot be used in the removal of extra skin.

Recovery

This is one of the fast healing surgeries that I undertake. However, it is important that you adhere to all the postoperative procedures that are given. This will include instructions about iced eye pads, bandages and taking of antibiotics if prescribed. I will also offer detailed instructions about the normal symptoms and any signs of complications. The amount of recovery also varies among people so it’s good to be patient and not rush things.

Risks

Fortunately, eyelid surgery has very minimal complications. Thousands of people undergo successful blepharoplasty and are happy with their transformation. However, all surgical procedures come with some degree of risk. Some of the complications may be watery eyes, infection and bleeding, allergic reactions, sensation changes, asymmetrical scarring and haematoma.

Question: What is the most troublesome thing you find with droopy eyelids? You can leave a comment below.

Can you achieve the perfect nose?

Rhinoplasty or nose surgery is one of the most common cosmetic procedures. You only notice the nose if it’s too big, too wide, or seems to be misshapen. In these type of cases, most people would want to have a rhinoplasty, also known as a nose job, to make an improvement in their appearance and thereby, increase their self-confidence and quality of life. Rhinoplasty are also performed to correct an accidental fracture or to improve chronic nasal congestion. In such cases, the surgery falls under functional surgery.

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Who Are Good Candidates for Rhinoplasty?

Rhinoplasty is suitable for anyone in good health. It is advisable that the procedure be done on a fully developed nose. Complete maturation of the nose is developed by the age of 16 for girls and 18 for boys. The commonest age group for a rhinoplasty are the late teens and early twenties. Adolescence and early adulthood exposes individuals to great pressure from their peers and society with regards to the way they look. Having a nose that is unappealing places enormous stress on one’s self-esteem and can cause severe effects on a teenager’s confidence.
Fixing bumps or making the nose smaller usually gives the face better proportion, leading to an improved appearance that will give teens and early adults the confidence they need to tackle  life and their foray into the real world. Older individuals who have rhinoplasty done either do it for cosmetic or for functional reasons, the latter usually to correct difficulty in breathing caused by chronic nasal congestion and other conditions.  For many, a drooping and sagging nose caused by ageing makes them look a lot older and having rhinoplasty can rejuvenate them again.

Insurance Issues

Cosmetic surgery is generally not covered by health funds. However, when a rhinoplasty is needed to correct an injury like a fracture, nasal obstruction, or to correct a congenital nasal deformity, then it can fall under functional surgery and therefore be covered. It all depends on the reason behind the nose job. Make sure you know what your medical insurance covers so you know how to proceed with your planned surgery.

The Steps to Having a Rhinoplasty

Before you consider a nose job, make sure you know where to have it done. Do your research and choose the best clinic or plastic surgeon who will help you achieve the look you want for your nose.  Set an appointment with the plastic surgeon and gauge whether or not you are comfortable and confident with the professional who will be doing the procedure. If everything is in place, such as the look you are going for, the budget, and the schedule, then it’s time you make the appointment for your rhinoplasty. Advanced technology like the VECTRA 3D Imaging System is available in certain clinics, which provide you with computer simulations of your before and after pictures. If you don’t like what you see, you can discuss further with your plastic surgeon about how you want the structure of your nose to look like.

What to Expect with the Rhinoplasty

Rhinoplasty is an outpatient procedure performed under general anaesthesia. The entire procedure takes about 1 to 3 hours or longer for complicated cases. Most plastic surgeons today perform an open rhinoplasty where the the incisions are made just under the nose, as well as,  inside the nose so the scars are inconspicuous once the nose heals. Depending on what needs to be done, plastic surgeons either remove bone and cartilage to make the nose smaller, or add tissue to make it bigger especially in Asians and African-Americans. Once this is done and the structure of teh nose is in place, the skin is re-draped and the incisions closed with fine sutures. A splint is then placed on-top of the nose to provide support to the new shape until it heals.

Recovery

Patients can go home after a rhinoplasty but for more complicated surgeries, patients would need to stay overnight at the hospital. Splints are usually taken off after 7 days. Many patients get to return to work after 1 week but swelling and bruising will still be present. Expect your face to feel puffy, especially on the areas around your eyes and nose. Swelling usually improves after 10-14 days.

Risks

The risks involved with rhinoplasty include infection, bleeding, nasal blockage due to swelling, and asymmetry. It is best to consult with your plastic surgeon should there be any unexpected side effects of the procedure.

Question: What do you think are the  main benefits of rhinoplasty? You can leave a comment below.