My hands make me look old!

 

People often focus their attention on keeping the face looking young. But your hands can also give away your age. I’ve discussed treating sun damage to the hands, but what about if your hands are starting to look too thin, with prominent bones, tendons and veins? You may not know this, but filler can be used in not only the face, but the hands as well! Radiesse has recently been approved for use by the FDA for use in the hands. It was commonly used in the hands prior to this approval as an “off-label” use, and it is the first filler to obtain FDA approval for this use.

Radiesse is injected in the office. The entire procedure takes about 20-30 minutes. Numbing cream is placed on the hands before injection to help make the procedure more comfortable. And I think the results speak for themselves- check out the photos below!

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

What if my family doesn’t want me to have Plastic Surgery?

Having Plastic Surgery is a big decision, and it is common for families to want to weigh in on the topic. But what do you do if your family is against you having surgery? This is actually a scenario that I see a few times a year. Before I delve in to how I help patients through this type of situation, let’s talk first about the financial aspect. Cosmetic surgery can be expensive. If your family or spouse doesn’t support your decision because they don’t think you as a family can afford it, you need to approach this like you would any big budget decision. Finances affect the entire family, so this is definitely an area where you and your spouse need to be in agreement. But if you’re single, and you are responsible for your own finances, it really doesn’t matter what other people (e.g. your grown children, friends, you parents) think. Your finances are your decision.shutterstock_325360154

With that out of the way, there are two other common objections that I see family and friends make.

  1. They worry about your health and safety. Whether you are medically a good candidate for surgery is a decision that should be made by your surgeon, possibly with input from your primary care physician. I have had family members tell me that they don’t think their mother or father is medically healthy enough to have surgery, but when I review the patient’s medical history, there is actually nothing concerning that would increase the risks of surgery. The only thing you can do here is to reassure your family that your doctor thinks you are medically healthy enough to have surgery. Seeing your family doctor for additional input may put your family’s mind at east, as this information would be coming from a trusted and known source, rather than a doctor you’ve just met.
  2. They don’t think you need surgery. This objection comes up quite frequently. And this isn’t really surprising, because it’s a value judgement. If something bothers you, that is all that is important. Now granted, people do sometimes obsess over an area of the body that actually needs minimal improvement. And this is where your surgeon’s judgement is important. If I think that I can make a visible improvement that will make a patient happier, then I recommend surgery. But if I think that no improvement is possible or that the patient won’t be happy regardless of the results, that is not a patient I offer surgery to.

To summarize, the financial aspect of surgery is a decision that should be made as a team if you are married or otherwise share finances with someone. But if finances are solely your decision, then the opinions of other family and friends don’t matter. The other aspects of the decision to have surgery are 1) whether you are medically healthy enough, and 2) whether you’ll be able to achieve the results you want. Those parts of the decision should be made in collaboration with your surgeon and your primary care physician.

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

Are medical-grade skin care products really better?

Yes! There is absolutely a difference between the skin care products offered over the counter and skin care products sold by physicians.glowing skin

  • The products sold in doctor’s offices contain higher concentrations of active ingredients, meaning they are generally more effective. Treatments for brown spots are a great example. The skin lightening creams available at your local pharmacy contain 2% hydroquinone, the active ingredient which blocks your cells from making pigment. But skin lightening creams available through your Plastic Surgeon have 4% hydroquinone.
  • When you see a Plastic Surgeon or a Dermatologist for skin care products you get the benefit of a skin care plan tailored to your needs. A skin care product may be incredibly effective, but it won’t help you if you’re using it for the wrong reason. Along those same lines, a physician can diagnose what is really going on with your skin, and treat the underlying cause, not just the symptoms.
  • Sometimes your skin takes time to adjust to new products. A doctor can tell you if what you are experiencing is a normal side effect, or if you should stop the product or try a different product instead. Tretinoin (aka Retin A) cream is a great example of this. Tretinoin is very irritating to the skin, so many people stop using it before they see results. But Tretinoin can give some amazing results in terms of smoothing fine lines and evening out pigmentation, if you are able to get through that adjustment period. A doctor experienced with skin care can help you adjust your use to minimize skin irritation, or even prescribe other products to calm down the initial redness and flaking.
  • Plastic Surgeons can also recommend where best to spend your money if you have a limited budget.  Skin care products are a way to help augment the results I achieve from laser procedures, Botox, and fillers. Which means I care about your results, not making a commission. I can tell you which skin care products to purchase at your local pharmacy to save you money, and which ones you really need to buy at my office to see results.

Do you have a question about skin care products? I would love to answer them in the comments section!

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

Is there a non-surgical lower eyelid lift?

Aging lower eyelids can make you look chronically tired, even if you are well-rested. Several things happen during the aging process:

  • Skin texture changes, becoming more crepey in appearance.
  • Skin elasticity decreases, resulting in excess skin over the lower eyelids.
  • The connective tissue that spans between the cheekbone and lower eyelid, called the orbital septum, stretches out with age. This allows the fat which surrounds the eyeball and protects it to “pooch out”, causing bags under the eyes (see the image below).

    lower blepharoplsaty

    Original photo from emedicine.com

The gold-standard way to fix this is, of course, a lower eyelid lift (blepharoplasty). A blepharoplasty removes a small amount of the fat causing the bags under the eyes, and removes the excess skin as well. But what if you’re not ready to commit to having surgery?

There isn’t a non-surgical way to actually fix bags under the eyes, but we can camoflauge them. Adding filler at the top of the cheekbone to make the cheeks fuller will smooth the transition between the lower eyelid and the cheek. The filler I like for this area is Radisse®. Radiesse® is composed of calcium hydroxylapatite, a mineral found in your bones. It is gradually broken down by the body over 9-12 months, so it gives fairly long-lasting results. The key with filler is to place it over the cheekbone, not the actual lower eyelid. Lower eyelid skin is very thin and delicate, so filler can look unnatural in this area.  The picture below outlines ideal filler placement with the blue dots. lower eyelid filler

Do you have a question about lower eyelid rejuvenation or cheek filler? I would love to address your questions in the comments section!

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

How can I make a scar less noticeable?

Making a scar less noticeable is one of the primary goals of plastic surgery. But to accomplish this goal, we first need to understand what makes a scar more visible in the first place. Let’s break it down:

  • Color: scars optimally fade to slightly lighter than skin tone. But some scars may remain pink or red, or even darker than the surrounding skin (hyperpigmented). It can take 6-12 months for a scar to finish fading, so redness or pinkness is normal during this stage. If the pink color persists beyond this time, or if you’re just a bit impatient, laser treatments can help the pinkness fade. Hyperpigmentation in scars occurs when they are exposed to the sun. To prevent this, I recommend applying sunscreen to the scar daily over the first year. If hyperpigmentation is already present, skin lightening creams can help even out the pigmentation, as can laser treatments.
  • Contour: an ideal scar is narrow and flat. But some scars may become thick and raised during the healing process, as I’ve discussed in a previous post on hypertrophic scars. This commonly occurs in scars on the chest, and some people are also just more prone to forming raised up scars. Silicone scar cream, massaging the scar, and steroid injections can all help flatten out a raised scar.
  • Width: instead of becoming thicker, scars may instead widen during the healing process. This is very common on the arms, legs, and back where the skin is under more tension. I have noticed that scar widening also seems to occur more often in teenagers. Keeping a steri-strip or piece of medical tape on the incision for the first several months can help decrease tension on the incision and lower the risk of the scar widening. But widening cannot always be completely prevented.

    photo credit: emedicine.com

    photo credit: emedicine.com

  • Blending into natural anatomic boundaries: you may have noticed that all of the above factors depend on the healing environment, i.e. how the wound is taken care of, and intrinsic healing factors that vary from person to person. But how the wound is closed also impacts how a scar develops. Wounds under significant tension are more likely to widen or raise up, so minimizing this tension through different closure techniques is an important part of plastic surgery. In addition, a good scar will blend into natural anatomic boundaries. This isn’t always an option in a scar resulting from trauma, e.g. after a dog bite. But if I am taking a skin cancer off the nose, for example, I can design the incision in a way that makes it less noticeable. Facelift incisions are another great example. Even though the incision is right on the face, placing on the natural boundary between the ear and the cheek makes a good facelift scar nearly invisible.

Do you have any questions about scars? I would love to hear them in the comments section.

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.