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Facial Contouring and Sculpting

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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Best Filler For Lip Injections?

After using every filler on the market in search of the holly grail, I have narrowed it down to only a couple of fillers.  I have injected every type of lip, with every type of filler, and we are talking about THOUSANDS of lips.  If you ever spend enough time on Instagram you will see all types of fillers being used to perform lip injections.  I will list the worst and best for lip injections- Starting with the WORST…Restylane wins hands down.  Unfortunately this filler is a very thin filler and looks great for a couple weeks, then say goodbye to those lips and you money.  Restylane is a great filler for people who do not like to do lip injections, or they are not good at lip injections.  Restylane is very pliable and corrects easily after any mistakes.  I have so many complaints, and people upset that they were pushed to use Restylane in the lips.  Restylane is sold as a “Natural and Soft” lip filler.  Unfortunately these injectors are heavily influenced by sales reps who have never touched a syringe, but regurgitate what their company tells them to say.   The second worst filler for lips would be Volbella, Vollure, or Belotero.  Again, these are too thin of fillers and break down extremely quickly.  These fillers do not hold their shape and are just too soft to last in a very animated area of the face.  The sad thing is I see many plastic surgeons using these fillers for lips… most likely because they are not good at doing lip injections.  These fillers should be reserved for other areas of the face, which they work very well in. My favorite is good old Juvederm Ultra XC.  Many years ago the drug reps told me to use Juvederm Ultra Plus XC in lips because “It lasts longer” which was not true.  Why did the rep want me to inject Ultra Plus???  Because it cost more.  Unfortunately now both Ultra and Ultra Plus are the same cost to buy.  Juvederm Ultra lasts about 6-12 months.  This filler will have a stiffer fell for the first 3-4 weeks until it softens.  We have had patients lip filler last Juvederm last 2-3 years!!! A new filler on the market as of today is Restylane Kysse.  So far we have heard good things about this filler, but we have not injected enough to know its true potential.  This filler has a much smaller needle (which generally means it is not a thick filler) which makes it much less painful for patients getting their lips done. These views on fillers are strictly our own point view, and the findings are after thousands of lip injections performed.

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Med Spas To AVOID

I have spoken to a lot of people about miserable experiences they have had with other medspas.  Here is what I have learned, and maybe this can help you find the right place. -Does the medspa or office offering services refuse to give out prices over the phone?  This is a red flag.  A reputable office should be transparent with pricing so that you can get an idea of what you will spend before going in. -Do you get stuck in a room with a “Sales Consultant”?  I would say to just walk out at that point, because they are trained to suck as much money out of you as possible.  Sales associates work on commission and don’t care about your financial situation.  They will be more than happy to set you up on Care Credit to get you financed for your services. -Is the office dirty, and the front desk personal rude?  As they always say, first impressions are everything. -Always make sure you know how long the person has been performing the treatments that you are going to get.  Typically a new person will not have the same amount of experience as someone that has been doing that procedure for over a year. -Groupon?  Sometimes Groupon is great, but when it comes to messing with your face spend the extra couple of dollars. -Bait and switch.  I really hate to say it, but there are places that will advertise cheap prices for Botox, then switch another product.  Always offer to come back if they are out of something you really want.  Make sure the product is where you can see it. -Avoid places where people always talk bad about other medical spas.  When people talk bad about other places, it shows they are threatened by competition.  A good medspa will keep their opinions to themselves and focus on you the client.

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Why Trusculpt ID out performs Coolsculpting

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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HydraFacial – clean, extract and hydrate the skin

The Hydrafacial is an award-winning system that merges invigorating spa therapies with advanced medical technology to enhance skin health.  The HydraFacial uses patented Vortex-Fusion® technology to cleanse, extract and hydrate.  The HydraFacial helps uncover a new layer of skin with exfoliation and resurfacing.  Remove debris from pores with painless suction, while you nourish with intense moisturizers that hydrate the skin. The facial treatments can be customized to each persons needs and skin types.  HydraFacial Brightalive® Booster Serum is a super serum designed to brighten skin tone and lessen the appearance of discoloration for an instantly gratifying glow.   You can also add red or blue light therapy to the treatment for added benefits.  In cosmetics, LED light has several purported uses: Red light is for anti-aging and inflammation, blue light is for acne, and infrared light to tighten and firm the skin. … Red light stimulates collagen, and blue light kills an acne-causing bacteria called Propionibacterium acnes Another great therapy from the Hydrafacial machine is Lymphatic Enhancements.   Removes toxic buildup to reveal healthy looking skin, helps detoxify the skin, decreases inflammation, removes unwanted buildup, and optimizes skin health

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Voluma – Radiesse

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

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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Lip Injections

Lip injections are defiantly an art.  Before getting your lips done, always look for pictures of what you like.  By showing photos to the injector, this will help them get a better idea of what they need to do.  Before lip injections, it is good to know if you have a tendency to get cold sores.  If you are prone to getting cold sores, I would highly recommend starting on an antiviral such as Valtrex the day before and day of the procedure. Do you research as far as what type of product they like to use for lip injections.  I prefer to use Juvederm Ultra XC, because of its longevity.  Other fillers such as Restylane, Volbella, Vallure, Bellotero are a total waste of time and money.  The reason I say this is due to the fact that the molecules in these fillers are very small and break down quickly.  Many inexperienced injectors like these fillers because they are easily correctable when they make a mistake. Always research and look at their before & after photos of lip injections that they have done.  Believe it or not, some places do a very poor quality of lip injections and actually steal pictures from other medspas and take credit for the work.  I hope this blog helped inform you about the decision to get your lips filled.  We perform thousands of lip injections and create some of the best lips.

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PDO Facial Threading

PDO facial threading has become a very popular procedure recently.  This procedure has actually been around for over 10 years, but has again gained traction in aesthetics.  Many years ago the “Threads” were made of a material that did not dissolve.  The new threads are now made of a material called Polydioxanone which dissolves over a period of time.  There are many different types of threads, which all depend on what area of the body you are working on. The results all depend on the providers experience and training.  Many providers try and use 3 or 4 threads to lift sagging skin.  When I perform a “thread lift” i generally do not like to limit myself on how many threads I use.  I always explain to people that the more threads I use, the better the weight is distributed and not relying on a few threads to hold everything up.  This is one of my favorite procedures because I get such great results.

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Laser hair removal

There are many types of different laser hair removal places out there, but which one is the best?  I can honestly tell you that corporate run medical spas will over charge you.  If you are paying $5000 for laser hair on your legs, your getting ripped off.  If you are paying for a Groupon, your probably getting ripped off.  I few tips for getting the most for your money… IPL laser hair removal is a total waste of your time and it will do nothing!  They love to market this type of hair removal as “Painless”.  It is painless because it does not work.  You need to be looking for a newer machine that is no older than 5 years old.  Technology in this industry changes so rapidly that better lasers come out every couple of years.  You also want to have the energy level turned up each time, if you can tolerate the pain since you will get better results.  If you do your laser hair at the same energy level every time it will not do anything.  Shave before your treatment, and do not wax.  When you wax the hair is removed and leave nothing for the laser to detect.  If you wax before laser treatments you will not get results and be wasting your money. I hope these tips help you get the best bang for your buck!!

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