“The main hesitation concerning injectables is the amount of pain and bruising associated with the procedures,” said Dr. Stong. “This revolutionary, state of the art injection technique is effective in achieving optimal results with virtually no social downtime. I also believe they are in the patient’s best interest to avoid the pain, swelling, and bruising associated with traditional injection techniques.”

Injectable Facial fillers, such as juvederm, restylane, and radiesse, are a minimally invasive option for treating wrinkles and folds, softening lines, and plumping lips. Traditionally, sharp-tip needles are used for injections to fill facial wrinkles and folds, accentuate facial features, as well as volumize lips. However, needles have several adverse characteristics. They are sharp and during introduction into the area to be treated, can tear blood vessels and nerves, causing pain and bruising. They also require repeated insertion to achieve results. Bruising and swelling from conventional needles can last for a number of days.

The new injection technique reduces damage to the facial soft tissues. A special cannula is inserted that allows access to large areas of the face through a single port. The selected product is then injected for an immediate, fuller, natural look. Nearly any area of the face can be accessed with this technique. Previously problematic areas such as hollow cheeks, vertical lip lines, and nasal labial folds are treated more effectively and accurately. They are also ideal for lip augmentation as it tends to be painful and often requires numbing the area. “Instead of using a sharp needle to puncture the lip several times, I make a small puncture at the corner of the lip. I then inject the lip with filler creating fuller lips” said Dr. Stong. “This technique is more effective in attaining a smoother fill with minimal time commitment by the patient,” he said.

Dr. Stong is one of the few physicians currently offering the technique, which requires proper training. He has also received excellent feedback from patients wishing to delay or avoid a more permanent procedure such as facelift surgery.

About Kalos Facial Plastic and Reconstructive Surgery: Kalos Facial Plastic and Reconstructive Surgery specializes in providing the most advanced techniques in facial plastic surgery providing the best outcomes for patients. Owner and facial plastic surgeon, Dr. Benjamin Stong is dual board certified in Head and Neck Surgery and Facial Plastic and Reconstructive Surgery. His extensive training in Head and Neck Surgery provided a foundation in surgical techniques and concepts critical to a better understanding of Facial Plastic and Reconstructive Surgery. http://www.kalos-plasticsurgery.com.

     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

               Early on in the evolution of rhinoplasty surgery almost all surgeries were performed through a closed technique.  With a closed technique, there are no external incisions as all incisions are made on the inside lining of the nose.  This gave surgeons excellent access to the upper two thirds of the nose allowing for good control in nasal dorsum surgery, or bridge work, and the ability to take down nasal humps.  The lower third of the nose is constituted by the nasal tip and nostrils.  With the closed technique, access to the tip is limited and subsequently modification of the tip is more challenging with this approach.  There are many surgeons who get good tip results with the closed approach, but the technique left something to be desired and led to the development of the open structure rhinoplasty technique.

               Open structure rhinoplasty uses different incisions than the closed technique allowing improved access to not only the tip, but all nasal structures.  The open technique places an imperceptible incision in the skin of the partition between the nostrils, called the columella, and along the inner rim of the nostrils exposing all structures of the nose relevant to cosmetic rhinoplasty.  This technique allowed for better tip refinement, as well as improved work on the upper two thirds of the nose.

               The choice of surgical technique is dependent on the individual’s specific needs and the experience of the surgeon.  Some plastic surgeons exclusively perform either the closed or open technique and others perform both techniques, allowing for a more diverse ability to shape and remodel the nose in cosmetic rhinoplasty.

               Facial plastic surgeons are extensively trained in head and neck surgery during residency, gaining a superior understanding of both form and function of the nose.  Some facial plastic surgeons go on to complete an additional year of training in fellowship where they intensively focus their studies and immerse themselves exclusively in facial plastic and reconstructive surgery. During this additional time they are honing their surgical skills.  Dual board certified facial plastic surgeons are board certified in head and neck surgery and facial plastic and reconstructive surgery.  Searching for a fellowship trained, dual board certified facial plastic surgeon who is familiar with both open and closed rhinoplasty techniques, will give a patient the greatest chance to find a very well trained rhinoplasty surgeon, with a diverse technical skill set for the best outcomes.

Posted by: Benjamin C. Stong MD

Atlanta, GA

      With less comprehensive techniques, such as plication or lateral SMASectomy procedures, there is less skin removed, the results do not last as long, and they are not as dramatic.  Although much of the marketing about the less comprehensive techniques is geared towards promising minimal healing times with equal results, the counter opposite is true.  Healing times are equal or even shorter with more comprehensive techniques such as the mini deep plane facelift, and the results are better with improved longer term results.  The most comprehensive facelift is designed to last eight to ten years, but with other techniques results can fail as early as one year after surgery.

      Most patients prefer to have fewer surgeries with the longest lasting outcomes.  Revision facelift surgery is done for two reasons: because of suboptimal results from a previous suboptimal surgery, or as a natural consequence of the continued aging process after a facelift.  Even with the best facelift techniques, patients may undergo several facelift surgeries in their lifetime to maintain a youthful look over the last two to four decades of their lives.

     The most proven facelift techniques are the extended sub-SMAS and deep plane facelifts.  Both techniques can now be performed through the most state of the art Mini Facelift incisions.  Older, more traditional facelift incisions were unnecessarily long, creating more obvious scars that required patients to change their hair styles to camouflage their incisions.  With contemporary, shorter incision techniques, patients can wear their hair as the desire, even in a pony tail.

     Facial plastic surgeons are highly skilled, specially trained physicians that are exclusively trained in head and neck anatomy and surgery with additional, advanced training in facial plastic and reconstructive surgery procedures.  When choosing a facial plastic surgeon, one should look for a surgeon that is dual board certified in Head and Neck Surgery and Facial Plastic and Reconstructive Surgery. This insures that the surgeon has met the rigorous standards required for training and certification to become a facial plastic surgeon.  Finally, when choosing a facelift surgeon, a patient should choose a surgeon they trust and have a good rapport with, in order to avoid suboptimal and sometimes disastrous outcomes.

Posted by: Benjamin C. Stong MD

Atlanta GA

Dr. Stong resides on the national FACE TO FACE committee; a humanitarian program of the Educational and Research Foundation for the American Academy of Facial Plastic and Reconstructive Surgery. FACE TO FACE is designed for facial plastic surgeons to donate their time and skills to help those in need of reconstructive facial plastic surgery including: victims of domestic violence, children afflicted with congenital birth defects, such as cleft lips and palates, and wounded veterans of the war in Iraq and Afghanistan.  “I was astonished at the number of domestic violence victims presently in Atlanta,” said Dr. Stong.  “Most of these victims are not only affected emotionally, but also left with physical evidence of the abusive relationship.  My goal is to contribute to the healing process by helping repair their physical and emotional scars.  Although this is only an initial step, we are optimistic about helping these survivors of domestic violence as well as provide future support to the PADV.”

Northside Hospital will collaborate with Dr. Stong by waiving facility and anesthesia fees for victim’s surgeries. For 14 consecutive years, Northside Hospital has been voted by Metro Atlanta consumers as the Most Preferred Hospital for Overall Healthcare Services.  Additionally, Northside Hospital performs more surgeries than at any other Georgia Hospital.

The PADV’s mission is to end the crime of intimate partner violence and empower its survivors. Since 1975, they have provided professional, compassionate, and influential support to battered women and their children in metro Atlanta.  It is a prestigious organization that helps restore victim’s confidence. The PADV also works to end domestic violence by restoring self-sufficiency and control to victims as well as educating the public on the dynamics of this complex issue. Meagan Fulmer, the Vice President of Development for PADV, approached Dr. Stong after learning of his generous contributions to other charitable endeavors.   “The PADV is excited to welcome Dr. Stong into our family. To have a surgeon of his skill set willing to work in partnership with us to help survivor’s of intimate partner violence not only overcome their emotional and physical barriers, but also help them thrive through the gift of healing,” said Meagan.

Aside from providing surgical services, Dr. Stong will host a charitable benefit November 4th at the Mason Murer gallery from which all proceeds will benefit the PADV and the national FACE TO FACE program.  He and the Kalos Facial Plastic and Reconstructive Surgery staff will also participate in the annual Hearts with Hope signature fundraising event of the PADV.  The proceeds from the gala go to support violence prevention, emergency intervention, and long-term advocacy for battered women and children.

The domestic violence initiative partners facial plastic surgeons with their local domestic violence advocacy programs to provide pro bono surgery to victims of domestic violence.  After a comprehensive screening process by the face to face program, victims of domestic violence are sent to facial plastic surgeons for reconstructive surgery at no cost to the patient.  In addition to donating their surgical skills, many facial plastic surgeons are involved in fundraising for the local domestic violence coalitions and shelters that provide such essential and necessary services for the victims including protection of the victims and their children.

The international reconstructive effort is aimed at helping children in underdeveloped countryies who are in need of reconstructive surgery and either don’t have access to medical care or can’t afford the surgeries.  The vast majority of these surgeries are congenital craniofacial anomalies such as cleft lips and palates and microtia (malformed ears), as well as deformities from traumas and burns.  The surgeons incur the cost of funding the trips bringing all of the equipment and personnel to set up fully functioning clinic, operating rooms, and recovery areas for the children and their families.  Often these trips are a week long and go all over the world wherever there is a need.

The newest initiative of the Face to Face program is the Faces of Honor program.  This program was designed to help soldiers who have facial deformities as a result of being wounded in combat.  Similarly to the domestic violence victims, these soldiers receive pro bono surgeries from facial plastic surgeons who donate their time and skills to correct the veteran’s deformity.

Facial plastic surgeons are dedicated to their craft and enjoy giving back to their local communities as well as around the world to those in need.  Facial plastic surgeons also perform many cosmetic surgeries including: facelift surgery, rhinoplasty, blepharoplasty, midface lifts, brow lifts, hair restoration surgery, otoplasty, scar revision, and laser skin surgery.  Facial plastic surgeons provide a comprehensive skill set for reconstructive surgery in the head and neck.  The face to face program allows them opportunities to give back to society through a collaborative organized effort.

Posted by: Benjamin C. Stong MD

    Many of the mini facelift surgery techniques available today can only offer short term corrections for their aging jawlines and neck.  Most patients want to have the longest lasting results in order to avoid additional surgeries and healing periods and requiring fewer surgeries during their lifetime.  Revision facelift surgeries are often more challenging for the surgeon and more expensive for the patient, and getting it right the first time is of paramount importance.

    Expert facelift surgeons agree that the deep plane facelift provides the most superior outcomes and long lasting results in facelift surgery techniques available today.  Older, more traditional facelift incisions have been associated with unacceptable scarring that can be difficult for the patient to camouflage.  In recent years, cosmetic surgeons have refined facelift incisions to develop the shortest, least noticeable facelift incisions.  These incisions have several different names including: the s-lift, short scar facelift, endoscopic facelift, and mini facelift.

     Until recently, the deep plane facelift was unable to be performed through the tiny hidden incisions of a mini facelift.  A few national and international expert facelift surgeons have refined the technique to be able to perform the deep plane facelift through these shorter facelift incisions.  Dr. Benjamin C. Stong at Kalos Facial Plastic Surgery trained with one of these advanced facelift surgeons and now delivers this superior facelift procedure to his clients in the Atlanta metropolitan area and patients throughout the United States as well as the world.

    An additional benefit to the mini deep plane facelift, is that it can be performed safely in smokers as well as revision surgery patients with the shortest downtime, thereby getting patients back to work and their social lives as fast as possible.  Laser skin resurfacing can also be performed safely during the deep plane facelift avoiding significant complications associated with skin resurfacing procedures with other facelift surgery techniques.
 

    The mini deep plane facelift is safe and effective in all age groups, genders, and skin types.  Kalos facial plastic surgery is the first to offer this technique in Atlanta and the surrounding areas.  The cost is similar to other facelifts widely available today, just without the uncertainty of the outcomes.  Finding a surgeon who performs this procedure is critical to achieving the best and longest lasting results.

Posted by: Benjamin C. Stong MD

      Hyperbaric oxygen (HBO) therapy has been popularized in the main stream media through several celebrities for its anti-aging effects.  In the scientific literature it has been demonstrated to hasten wound healing by promoting free radical scavengers, reducing cell damage, and increasing the oxygen delivery and blood supply to wound beds.  For years, hyperbaric oxygen therapy has been used to facilitate healing in chronic, non-healing wounds.  Ultimately, the common pathway in hyperbaric oxygen therapy is more rapid wound healing.  A new, unique application for HBO therapy is to assist healing in facelift surgery.

      We performed a prospective, controlled study on thirteen patients undergoing face lift surgery with six electing to undergo HBO therapy immediately before and after their face lift.  Seven patients were entered into the control group and received no therapy.  Any additional confounding factors were equal and accounted for.  Statistical Analysis, digital photography and the previously validated objective computer model were used to assess the resolution of bruising postoperatively.  The result was a statistically significant decrease in the degree of bruising in the HBO group over the control group on postoperative days 7 and 10, with a 35% and 30% reduction, respectively.  There were no complications associated with the treatment group.

      This is the first report of the benefit of HBO therapy on wound healing in cosmetic surgery.  To date there has been no more compelling evidence for a particular adjunctive therapy to facilitate healing, with many of the current treatments having little scientific evidence supporting their use.  The validated computer model in this study provides the scientific community an excellent resource to objectively measure the resolution of bruising and healing following surgery.  Additionally, a larger number of patients enrolled in this study would empower the degree of effect on bruising and most likely become statistically significant sooner in the postoperative course.
 

     When patients are choosing to undergo facelift surgery, they should educate themselves on therapies that do and do not work.  This can often be difficult due to the current directed marketing strategies making promises that often go unfulfilled.  What the patient truly needs is a consultation with a facial plastic surgeon in order to decipher and discuss the information.  Hyperbaric oxygen therapy offers patients a statistically validated and scientifically studied adjunctive therapy to recover faster, following facelift surgery.  HBO in otherwise healthy patient’s is a safe, innocuous therapy with little downside.  Although it can potentially increase the overall cost associated with the surgery, it does offer patients seeking the most rapid recovery from facelifts a further treatment modality to employ in order to return to daily activities faster.  Due to the proven benefits, HBO should be included in the discussion with patients undergoing facelift surgery as a potentially beneficial therapy in the healing process and may be applicable to other plastic surgery procedures such as the midface lift.

Posted by: Benjamin C. Stong MD

Atlanta, GA

    Almost all Mohs surgery is performed under local anesthesia in the comfort of an office setting without the need for an operating room.  Insurance will pay for a plastic surgeon to perform the reconstruction no matter how simple or complex the closure is.  Benjamin C. Stong MD at Kalos has extensive, highly specialized training in complicated Mohs skin cancer reconstruction, and he provides a complete range of reconstructive options for patients seeking the absolute best outcomes from Mohs skin cancer removal surgery.  With a very high volume Mohs reconstructive practice, all closures, no matter how complicated, including: paramedian forehead flap reconstruction, tissue expansion, Gillies fan flap and Karapandzik flap lip reconstructions, eyelid reconstruction, cartilage grafting, melolabial cheek flaps, scalp reconstructions, full thickness nasal reconstructions, and cervical rotation advancement flaps can be performed in the comfort of a beautiful, peaceful office on the same day as the Mohs procedure avoiding the need for a hospital or ambulatory surgery center.
    

    With the use of local anesthesia and oral sedation there is almost no defect in the head and neck that requires a patient to be put to sleep to have the closure performed safely and comfortably.  With hundreds of complicated Mohs reconstructive procedures performed in the office setting, Dr. Stong has the experience and techniques to repair complex defects in the face and avoid the need for a cold, impersonal operating room.
 

    Many patients are often unprepared for the overall surgical experience and recovery process.  The biggest concern of most Mohs surgery patients is being put to sleep for the reconstruction and the quality of the reconstructive result following tumor removal.  Kalos: The Atlanta Center for Facial Plastic, Reconstructive & Laser Surgery and Dr. Stong routinely perform pre-surgical consultations to explain the reconstructive options and prepare the patient for the recovery process prior to undergoing Mohs surgery.  Pre-surgical consultation with a plastic surgeon is covered under most insurance plans, and is available to all patients who wish to get the opinion of an experienced Mohs reconstructive plastic surgeon and a better understanding of the healing process following removal of skin cancer.  Many Mohs surgery patients also desire consultation for effective skin rejuvenation and facial plastic surgery procedures such as rhinoplasty, facelifts, laser skin resurfacing, and eyelid lifts for facial rejuvenation to improve ones appearance.  Kalos offers a comprehensive range of medical grade skin care products, laser surgery, and facial plastic surgery procedures to support our patients’ needs.
 

    Insurance only covers a single reconstructive effort.  It is important to find a plastic surgeon with significant experience to perform a Mohs closure to achieve the absolute best outcome.  Additionally, Mohs surgery patients wish to avoid the inconvenience of waiting for days for either a hospital or an ambulatory surgery center operating room to become available as well as the lingering after effects of anesthesia.  The best outcomes from Mohs surgery involve a team of two separate surgeons: a dermatologist to remove the tumor and a plastic and reconstructive surgeon to perform the closure, with each being highly skilled in their respective portion of the procedure.  The ability to offer patients a completely office based Mohs reconstructive surgery center is unique and geared towards exceptional convenience and customer service.

Benjamin C. Stong MD

Atlanta GA

    The deep plane face lift can now be combined with mini facelift incisions to provide the maximum amount of correction available with a single facelift procedure while using the smallest incisions.  Many patients falsely believe that the “Deep Plane” facelift will result in longer healing times.  In truth, there is actually less bruising and risk of hematoma than with other techniques.  With the deep plane facelift the correction in the midface and nasolabial folds is less permanent than the correction of the neck and jaw line.  It is not as effective as a separate endoscopic temporal midface lift as a midface lift procedure.  Surgeons who perform the deep plane facelift have had specialized training in the technique because it requires an intricate knowledge of the anatomy of the soft tissues of the face and the facial nerve to achieve optimal outcomes and avoid complications.
 

    When consulting about facelift surgery, the overall expenses in addition to the healing period are foremost considerations.  Most informed patients are seeking to have a procedure that will offer the longest term and most complete correction, thereby decreasing the overall cost from unnecessary revision surgeries.  The deep plane facelift is currently one of two “gold standard” procedures, to correct the aging jaw line and neck, the other being an extended Sub-SMAS facelift.  It is the only procedure to offer a correction of the midfacial soft tissue drop and the nasolabial folds with a single procedure.
 

    Facelifts are often combined with other procedures, including: upper and lower eyelid blepharoplasty and brow lifts for a “full facelift” surgery.  In addition, a skin rejuvenation plan is important to add to surgical procedures to attain superior results.  Laser surgery and medical grade skin care products are often combined to offer the state of the art in skin rejuvenation therapy.  Consultation with an expert facial plastic surgeon is critical to developing a strategy to restore and preserve ones youth and beauty.

Benjamin C. Stong MD

Atlanta, GA