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Facial Contouring and Sculpting

Agnes /

When we talk about slimming the face or contouring the face, this can be done in different fashions.  Typically the lower part of the face is what people want to slim down in order to have that V shaped face.  Over time and with age, the lower part of the face tends to sag a bit.  With age we tend to get what are called “Jowls” that hang down.  These jowls result from a lack of supportive tissue and deep fat, which typically helps hold everything up and in place. Slimming the face can also be useful if you have a very round face, and you are looking for more definition. Fillers are the easiest way to lift up a small amount of sagging from the lower face.  Fillers need to be placed in the midface to help volumize the areas that have lost their deep underlying structures, such as fat.  Fillers can be a slippery slope, because you need to have the right amount of filler placed so that you do not become over filled.  People will often try and talk you into fillers and more fillers to lift the lower part of the face, leading to an over filled fat looking face.  Fillers in the face should be used with caution, and used more for balancing the face. Kybella can be used to remove fat from the lower part of the face as well.  Kybella is injected carefully into the lower part of the face, and only into the fat areas.  The injection of Kybella will result in swelling for 2-3 days.  You must keep in mind the swelling that happens when injecting Kybella, since some people have severe swelling after.  Kybella will need to be done at least 3-4 times to get the desired results.  The problem with Kybella, is that is indiscriminately kills fat, and not always in the exact spot you may want. Agnes is a new way to precisely destroy small areas of fat.  With this procedure, we can target very small areas of the face to remove fat.  Agnes allows us to actually chisel out and sculpt the face.  With this procedure, there will be some mild swelling as well, but not to the degree Kybella swells.  When we use this machine, we always like to combine it with Morpheus8 to help tighten as well for best results.  Agnes is currently the best way to remove small areas of fat, and it is what we get the best r with.

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TruSculpt for Killing Fat !!

Body Contouring /

Some great new technology to hit the market with amazing results is… TruSculpt ID.  What is TruSculpt?  TruSculpt uses radio frequency and heat to destroy fat cells.  Fat can be destroyed with heat, cold or chemical injections such as Kybella.  Up until now Coolsculpting was the most well known non-surgical way to destroy fat.  The problems with Coolsculpting was that it could cause nerve damage and leave the area numb for a month.  Coolsculpting also would cause a lot of bruising after the treatment.  Trusculpt ID leaves no signs of treatment, and there is no downtime.  The radio frequency used with TruSculpt also helps tighten the skin, whereas Coolsculpting kills fat and leaves the skin loose.  Multiple treatments are great to get to the ideal body that you are looking for.  The best part is that the treatment is ONLY 15 minutes!

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Why Trusculpt ID out performs Coolsculpting

Body Contouring /

Trusculpt ID is much newer technology than Coolsculpting.  We will list why Coolsculpting is outdated and why new technology beats old outdated technology. Trusculpt is a fast 15 minute treatment that is relatively painless.  There are 6 paddles that are placed on the skin and strapped into place.  Trusculpt uses radio frequency (RF) and heat to destroy fat cells.  You can destroy fat cells either by a thermal event such as freezing or heating, or chemically by injecting something such as Kybella.  Of course liposuction is the best, but not everyone wants liposuction or surgery.  Trusculpt provides results in about 8-12 weeks and has NO DOWNTIME.  There are no signs of treatment and you could literally go to the gym immediately after.  Trusculpt will NOT leave divots whereas Coolsculpting will.  There is also NO bruising involved, where Coolsculpting will. Coolsculpting takes about 45 minutes per area you are treating.  The area will be NUMB for about 4 weeks following the treatment.  Coolsculpting can also be used in limited areas, where Trusculpt can be used in many different areas.  The chances of bruising from Coolsculpting is very high and difficult to hide.  The area being treated with a Coolsculpting applicator must be massaged immediately after the applicator is removed.  The massaging part of the procedure is extremely painful due to the re-perfusion of blood into the area after freezing it. Both Trusculpt and Coolsculpting provide good results, but trusculpt provides a faster treatment.  Trusculpt can be used in tricky or hard to get to areas.  Cost is about the same on both.  Coolsculpting you will be numb for a month, and Trusculpt Zero downtime and no numbness.

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Voluma – Radiesse

Injections /

Voluma and Radiesse are two favorites for cheek fillers.  Both produce great results, but each one has it’s own pros and cons.  Voluma is a nice soft filler that comes in a 1ml syringe, whereas Radiesse is a 1.5ml syringe. Radiess has some characteristics that are called “biostimulators”.  A biostimulatory filler will cause the body to produce more collagen over time.  We have seen Radiesse last for over 2 years due to these biostimulatory traits, where Voluma will last about 12 months.  Depending on how Radiesse is placed, it mimics a injectable implant and can be firm.  Radiess can also have a soft feel when slightly hyperdiluted to help fill in large hallow areas.  Voluma is much softer and very natural feeling, which many people like.  Radiesse will tend to cause more swelling after injections than Voluma. Both are great fillers, but we recommend having your provider let you know what would be the best for you.

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Botox – Dysport

Botox /

Botox is great for helping to reduce the lines on the forehead, between the eye brows and around the eyes.  Botox works in the muscle by blocking the impulse going to the muscle which causes it to contract.  When there are strong muscles, it causes micro injuries into the epidermis of the skin which cause lines to form where the muscle squeezes together.  Botox or Dysport will not fill in deep lines or wrinkles, so we suggest a “filler” at the point.  Fillers are gel substances that help plump up sunken areas or deep lines. What is a good age to start Botox?  It is hard to say exactly what age is appropriate, but we typically recommend around the age of 30.  A lot of this has to do with the strength of the muscles, and not so much about the age of the person.  We have had 20 year old women with very strong muscles, and I have had 60 year old women with no lines and have never had Botox or Dysport before.  When you are younger, we typically recommend Botox every 6-9 months as more of a preventative measure. Is Botox Safe?  We uses thousands of units every month and have never experienced any severe side effects.  Possible side effects may include a slight headache, blurred vision and flu like symptoms.  These possible side effects only last 24-48 hours and resolve on their own.

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Botox

Botox /

When injecting Botox, you can not inject everyone the same way.  Muscles vary in location from one person to the next.  Having a trained injector who has a great deal of knowledge about the facial muscles will make your Botox come out much better.  When doing an assessment of a person’s facial muscles it is best to have them make different facial expressions to evaluate the muscles. When going to a new place, it is important to know what you want and what you don’t want.  Many places work on commission and will try and up sell you on more Botox than you may even need.  The problem is, when you have too much Botox it can cause the forehead to get very heavy and make the eyelids droopy.  If you don’t get enough injected you will still have a lot of movement and the lines will never go away.  The other problem with treating sub-therapeutically, or placing too small of an amount is that it will not last very long. Typically for the forehead I find the sweet spot to be 30 units of Botox or 60 units of Dysport.  Around the eyes can be a tricky place to inject because it is the highest rate of bruising associated with this area.  Blood vessels are very difficult to see around the eyes and it is a very tender area.  If you place too much Botox around the eyes it will effect the way you smile.

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Facial Injections

Injections /

When performing facial injections I prefer to achieve a natural look.  One way of avoiding over filling of the face is to make sure you see plenty of before and after photos.  I always recommend asking for photos and bringing a photo of what you looked like 10 years ago.  A major problem as we age is volume loss.  We loose fat, muscle and bone over the years.  This fat loss will lead to sagging of the face, because fat acts as a support structure under the skin.  There is deep fat as well as superficial fat.  Area that may have a lot of animation, such as around the mouth area, tend to get more lines and wrinkles.  Over filling the face may leave you with no lines or wrinkles, but it will also make people appear very artificial and overweight.  There are many fillers on the market such as Juvederm, restylane, voluma, radiesse.  A good provider will know which filler is appropriate for different parts of the face.

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Will I bruise with Botox

Botox, Uncategorized /

When doing Botox, it is hard to say if you will bruise.  There area areas that have a higher tendency to bruise, such as around the eyes.  There area a few things that will help reduce the chances of bruising, but there is never 100% chance of not bruising.  Many times it depends on the injector, whether they are aggressive with the needle, or do they take their time to look for blood vessels.  Things you can do to help reduce your chances of bruising are – Arnica Montana is a great homeopathic drug sold over the counter.  I typically recommend starting Arnica 3-4 days before injections.  Avoiding alcohol for a couple days before any injections will also help keep your blood from getting too thin.  Do not apply numbing cream to the area where you are getting injections.  Numbing cream causes the blood vessels to become dilated and puts you at a higher risk.  Ice before hand can help, but I never recommend ice after Botox, because it will interfere with the absorption.  If you get a really bad bruise, IPL laser can help break down the blood and help it heal much quicker.

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Botox

Uncategorized /

Botox is a great way to help reduce and eliminate wrinkles and fine lines.  I typically recommend starting Botox when you start to see fine lines in the forehead or around the eyes.  When adding Botox into your routine of anti-aging the benefits will pay off greatly down the road.  Many people ask what a good age to begin Botox?  Unfortunately there is no right answer since everyone has different types of muscle strengths.  I have had clients as young as 20 begin Botox, and other women starting at the age of 45.  When getting Botox for “preventative” measures, I generally let people know they need a smaller amount and not as frequent.  The best idea is to have a consult to determine whether Botox is right for you. Dangers of Botox… When injected incorrectly, Botox can cause a “Droopy eye” or when injected inside the orbital rim it can migrate into the muscles that move the eye causing a lazy eye.  I have personally injected hundreds of thousands of Botox units and have never had any serious problems.  The good thing is that Botox is not permanent and will wear off in 3-6 months.  I always encourage people to do their research before undergoing any type of cosmetic procedure.  There are plenty of good injectors, but finding the one you like can take time, so be patient and do your homework.

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Fibroblast Skin Tightening

Fibroblast skin tightening /

Fibroblast skin tightening has become a hot new trend in 2018 for achieving permanent, long lasting results.  Fibroblast has been very popular in Europe and Canada, and now made its way into the US.  Fibroblast creates small currents of plasma energy to burn off a small portion of the skin, causing a reaction that tightens the skin.  The plasma energy stimulates the small fibroblast cells to produce more collagen and tighten up the skin. During the procedure, you are first numbed with a topical numbing cream to decrease the amount of pain.   Depending on the size of the area being treated, the procedure may take 20-30 minutes.   We generally suggest to split up big areas to allow swelling to resolve.  Areas you can treat would include upper eye lid, lower eyelid, face, labia, stomach, stretch marks, jowls, and much more. The downtime is about 5-7 days where you will have small dots from the device creating small burn marks.  These spots will scab up and flake off in about a week.  We recommend not picking at them or scratching them off since this may cause scars or hyperpigmentation. This is a fantastic new procedure that offers long lasting results.

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