Archive for the ‘Botox’ Category
Facial cosmetic surgery is a very personal and monumental decision. Universally, all patients want the best outcomes. In today’s corporatized America, with heavily influential marketing spin, pharmaceutical companies, medical device companies, and even practitioners promote a less is more mentality to push products and services that often over promise and under deliver on the results. In no way can skin creams, injectables, or lasers deliver the types of results once can achieve with surgery. In a similar manner, minimally invasive sounding surgeries are in no way a substitute for time tested peer reviewed procedures that provide quality long lasting results.
Unfortunately not every person will achieve acceptable results with Botox or injectable fillers such as Juvederm, Restylane, and Radiesse. These products have their place in facial aesthetic practices, in properly selected patients, but in general should be viewed as temporary treatments with less impressive results when compared to surgery. Their primary advantage is that they have minimal social while providing a benefit. Botox is being used more and more as a preventative cosmetic medicine that delays wrinkle formation. Fillers camouflage initial signs of aging, but ultimately putting too much filler in a face, the liquid facelift, can alter ones appearance creating an artificial overinflated appearance. Using filler to augment facial structures can be useful to patients wanting to get a general idea of the appearance prior to permanent surgical procedures such as lip and cheek enhancements procedures. Creams reverse the signs of photo aging and contribute to collagen formation and production but are limited in their effectiveness. Lasers are an excellent option to delay the signs of aging and treat sun induced skin photoaging, but in no way can they tighten skin like facial cosmetic surgeries such as a facelift.
Surgical procedures are the best option for impressive endurable results. Rhinoplasty can dramatically affect ones facial appearance in a way that almost no other cosmetic surgery can. The nose can cause undue and unnecessary attention drawing attention away from other attractive facial features. Aging face surgery has many layers of effectiveness based on the surgical techniques used and how they are applied. In general, minimally invasive techniques can produce an artificial appearance and or short-term results. When considering aging face surgery most sophisticated patients are looking for surgeries that will last as long as possible with the most dramatic natural appearing results. There are no shortcuts to achieving optimal results and when applied, shortcut techniques frequently under deliver on the surgical results end.
Becoming an informed patient who understands the benefits of finding the right intervention or surgery for the right patient will ultimately save one time and money over the long haul. Getting things done right the first time is of paramount importance to achieving optimal outcomes with a high degree of patient satisfaction, while avoiding problems and bad outcomes.
Posted by: Benjamin C. Stong MD
The fourth and fifth decades of life are a time when people often begin to become more aware of age and committed to facial plastic surgery procedures. Accumulated sun damage and prior skin care rejuvenation regimens affect when patients begin to consider blepharoplasty, brow lifts, and facelifts during these decades. Often, patients will also add staged or simultaneous skin resurfacing rejuvenation procedures to maximize and augment surgical results. There is often a misconception that surgery and procedures need to be delayed as long as possible to avoid additional surgeries in the future. The truth is there is no good or bad time to under go surgical and skin rejuvenation procedures; it is only appropriate when a patient becomes bothered enough by the issue to consider surgery and is an intensely personal decision. The most important consideration to avoid bad outcomes and unnecessary surgeries is to find a practitioner who uses techniques that will provide superior, long lasting results.
Eyelid lift surgery or blepharoplasty offers a long lasting procedure and when performed correctly is often not necessary to have repeated in the future. Similarly, Brow Lifts usually only need to be performed once if the surgery addresses the laxity issues in the forehead, upper eyelid, and brow complex and adequately releases and re-suspends these tissues. Minor touch up procedures may be included in future treatments to maintain and maximize results from blepharoplasty and brow lifts. Revision surgery becomes important when considering revising suboptimal results from poor, inadequate techniques and is more difficult due to scar tissue from the previous surgery and is more expensive. Having a procedure performed correctly the first time is of paramount importance.
Facelifts are procedures that can be performed multiple times over a patient’s lifetime. To avoid unnecessary and costly revision surgeries, finding a surgeon who effectively releases and re-suspends the SMAS layer, the primary support layer, of the face is important. Many surgeons believe they get equally effective results with less aggressive work on the SMAS layer, but there is no short cut to providing superior long lasting results. When performed properly, a facelift can provide patient satisfaction for ten years, or more. A facelift addresses an aging jaw and neck line, resetting the clock, but it does not stop the clock from restarting. Some patients who want to be aggressive about hiding their age may choose to undergo two or three facelifts during their life. Another popular misconception is that undergoing multiple facelifts will result in a pulled or windswept look. The truth is that when the skin and deeper SMAS layer are pulled in the correct direction, a facelift can be performed as many times as desired to maintain a more youthful jaw and neck line. An additional misconception is that a comprehensive and thorough jaw, cheek, and neck lift can’t be performed through an abbreviated mini facelift incision. This notion is also false; a thorough facelift can be performed through the short scar, abbreviated, mini, s-lift facelift incisions safely with superior outcomes. Consultation with a knowledgeable facial plastic surgeon will allow for a comprehensive facial rejuvenation plan over the years when a patient is interested and healthy enough for surgical procedures.
Skin resurfacing rejuvenation procedures are important to consider when augmenting and maximizing surgical results. In addition to noninvasive lasers such as IPL LimeLight and YAG Laser genesis procedures, ablative resurfacing procedures become necessary to maintain youthful looking skin. Finding a practitioner who offers the state of the art laser rejuvenation procedures is necessary for excellent outcomes with the shortest healing times. Currently, combining confluent and fractionated laser modalities offers the best treatment for both superficial and deep discolorations and wrinkles as well as stimulating collagen formation. It also avoids complications and prolonged healing times from more traditional chemical peels and lasers. Laser resurfacing rejuvenation procedures can be performed as often as necessary to restore and maintain youthful, vibrant looking skin.
Botox, facial fillers, medical skin care products and other preventative and maintenance therapies should be continued in the forties and fifties to maximize the longevity of surgeries and skin rejuvenation procedures. Consultation with a knowledgeable facial plastic surgeon, who applies a global perspective when discussing patient goals and their future considerations, will put the patient at ease and establish trust that the practitioner is making thoughtful recommendations based on his expertise and training.
Posted by: Benjamin C. Stong MD
Botulinum toxin is a derivative of the toxin produced by the bacteria, Clostridium Botulinum. Immunization against the bacteria is customary with childhood vaccinations, and as such it is no longer relevant as an infectious disease risk. When injected locally the toxin weakens muscles allowing precise control of the effect. Initially the toxin from C. Botulinum was used to treat neuromuscular movement disorders. In the head and neck it was used to treat Blepharospasm (uncontrolled spasm of the eyelid muscles) and an uncommon voice disorder, Spasmodic Dysphonia. From there, the medical industry recognized its benefits and expanded its role into what is now the single most common cosmetic procedure in the United States. Until recently, Botox has been the exclusive producer and distributor of the medication within the U.S. In 2009, Dysport gained FDA approval with a reported quicker upstroke during the onset period of the medication. In the cosmetic industry they are both used to relax facial muscle groups softening existing wrinkles and delaying the onset of new ones. Additionally, advanced injection techniques, can lift the eyebrow and the corners of the mouth reversing some of the effects of aging. In no way can Botox be considered a substitute for the long-term, more dramatic effects of surgical procedures.
One of the most common areas treated on the face is the Glabella, the area between the eyebrows. This area is commonly used during facial expressions exhibiting anger and is also referred to as the furrow or the 11’s. As time marches on the vertical folds and wrinkles developing in the area deepen and increase in number resulting in an angry look. The Crows feet, or smile lines, is another commonly treated area. The degree of wrinkling in this area is a result of smiling, squinting, and sun exposure. Another very common area treated is the forehead, or worry lines, with wrinkle reduction balanced by maintaining the brow position. Other less common areas treated in descending order, are the perioral wrinkles around the mouth (smokers lines), the bunny lines over the upper bridge of the nose, the vertical bands that form in the neck, and less frequently, the chin for puckering that occurs with facial expression.
Botox can be used to provide a mild to moderate lift to the arch of the eyebrows and corners of the mouth. These two procedures are commonly referred to as a chemical brow and lip lift, respectively, and can restore the youthful arch to the brow and gentle curve to the corners of the mouth. Patients should be aware that this is a temporary effect and will not offer the degree of improvement that surgical brow lifts and lip augmentation procedures do.
Once wrinkles are well formed, muscle weakening therapies offer less dramatic results than when used as maintenance or preventative therapy. As a result many people initiate therapy in their late 20’s and early 30’s. Botox therapy can be combined with skin rejuvenation or surgical procedures for additional wrinkle reduction and more global skin rejuvenation. Following skin rejuvenation procedures, Botox therapy can delay the onset and formation of future wrinkles. Botulinum therapies, such as Botox and Dysport, offer a versatile noninvasive procedure to treat and prevent the onset and effects of aging. Optimally, Botox therapy should be initiated as a preventative and maintenance therapy and combined with future skin rejuvenation and surgical lifting procedures to deliver the best results and maintain a youthful appearance.
Post provided by: Botox Therapy Atlanta GA | Benjamin C. Stong MD