By Carolynn Grimes
ThePlasticSurgeryChannel.com

If you have a drooping jawline or jowls that needs correction, there is a  procedure that uses a patient’s own fat to fill in deflated areas.

They’ll say, “I don’t mind being forty or fifty years old, but I don’t want to be forty or fifty with jowls.” Dr. Patrick Sullivan, a board certified plastic surgeon in Providence, Rhode Island says sometimes this can be a condition that is inherited from your mother or father and there’s very little that can be done about a drooping jawline other than plastic surgery and sometimes weight loss.

Dr. Sullivan is a specialist in facial plastic surgery procedures and says people need to be very careful who they choose as their doctor for plastic surgery. Recently he consulted with a woman in her forties who was left with significant scars along both sides of her face along the jawline. Sullivan says the placement of those scars were not necessary for the result that she was looking for.

Dr. Sullivan uses a lifting procedure that is an extended inner lift with multiple layers, instead of just stretching the skin. He says he also looks at the chin region because often times people will have areas of deflation at the side, in front of the jowl. “These areas start getting more and more deflated causing the chin to look bigger,” says Sullivan, “and filling in this area with fat gives the jawline a smoother appearance.”

Many times he uses a patient’s own fat to fill in behind the jowl to give a better contour to the jawline. This procedure is particularly common in men who want their deflated jawline to look more masculine. For this procedure, Sullivan says, “rather than using a synthetic material that might get infected, if you use your own fat you’re using your own cells, which helps to keep the fat alive.” According to Sullivan, younger patients are the best candidates for this procedure. “We’ve done this in young people who want more of a chin. We put in fat along the chin area and maybe a little liposuction in the neck region to give a more artistic appearance to the lower face so it matches the nice features of their upper face,” says Sullivan. He says, “it’s all about artistic balance.”

Sullivan says the jawline is an area where he can help people of all ages.

“Sometimes it can be a very minimal procedure or it can be a more extensive procedure where we need to remove excess skin.” He says, “we are re-positioning tissue to solve the gravity problem.” Sullivan uses permanent stitches to lift the tissue and reshape the lower face. Using this procedure he brings out the cheekbones which he says “is really their own tissue rather than cheek implants.” Sullivan says “it gives a very nice jaw line with a balanced face that is no longer square but more oval shape, which tends to be much more enhancing in giving them a more natural and youthful look.”

Dr. Sullivan advises patients to bring in photos from their earlier years. “When patients bring in pictures of them in their 20’s, it is so helpful for me to see what they looked like.” He uses the photos as a gauge to help restore what time has slowly changed.

By Carolynn Grimes
ThePlasticSurgeryChannel.com

Whatever you want to call it, “Bro-tox” or Botox, men are now learning what women have know for years; that Botox injections can help them look younger and more refreshed, taking years off the aging process.

The number of men getting Botox and cosmetic procedures has doubled in the last 15 years.

Doctors verify that they are seeing more men come into their office, many times at their wife’s or girlfriends prompting. But also to gain a professional edge in the workplace. Dr. Caroline Glicksman a board certified plastic surgeon and board member for ThePlasticSurgeryChannel.com says, “In my practice, one of the leading drivers of men trying Botox is the positive influence of their wives and girlfriends. Although their personal reasons may vary, a man who has the emotional support and encouragement of his wife or girlfriend, is more likely to try Botox for themselves, and continue using throughout the year. ”

Some men consider Botox because they want to look their best and compete in the workplace.

Another reason Glicksman says is men want that competitive edge  in the workplace.  “One of the things I’m seeing more recently with the economy, a lot of men have to go through job interviews, they are competing a little bit, so it helps them feel a little bit better about themselves for an interview,” states Glicksman.

Botox is now the number one plastic surgery procedure for men. According to the American Society of Aesthetic Plastic Surgery (ASAPS), more than 2.4 million individuals underwent these procedures in 2010.

Dr. Robert Grant a board certified plastic surgeon says when men get a little older into their 30’s and 40’s they should start thinking about the use of fillers and neurotoxins like Botox and Dysport to keep them looking their best.  Grant says, “These can help very subtly restore some of the age related changes in volume of the face and the lines and wrinkles that make us look older before our time.

Dr. Glicksman says the ideal candidate is someone who wants to see how much better they can look without having surgery and taking time away from work. She states, neurotoxin injections have no down or recovery time, are inexpensive compared to surgical alternatives and are relatively low-risk.

However, Glicksman warns that “men should take Botox injections seriously and be evaluated by a board certified doctor before getting the procedure.”

Want to grow your own long, natural eyelashes?

The secret to long, beautiful eyelashes isn’t a secret anymore with the help of a new prescription on the market. For centuries women have always accentuated the appearance of their eyes by making their lashes look longer and thicker.

Dr. Robert Grant, a board certified plastic surgeon from New York says, Latisse makes it possible to get the lashes you had when you were younger or the lashes you’ve always wanted. “For the first time, we have a prescription medicine that actually grows more eyelashes,” says Grant. He says, not only will your lashes grow longer, but Latisse increases the number of lashes that you grow.Latisse is the only FDA approved drug on the market for the purpose of treating sparse eyelashes.

There are a few things the consumer should know before using Latisse for eyelash enhancement

1. According to Allergan, the maker of Latisse, the prescription medicine should not be used on the lower lashes. Enough of the medicine naturally gravitates to the lower lashes as your blink. If your eyelids become dry or itchy, the medicine can be used every other day. Grant says, Latisse can also be used by people who wear contact lenses.
2. Allergan recommends that the eye area be cleaned and contact lenses removed before application, then reinserted 15 minutes following the use of Latisse.
3. Most people see full results in three to four months. After your lashes are grown out to where you are happy with them, you can maintain them by using the drug every other day.

Can you  use  other eyelash products with Latisse?

To further enhance the look of your lashes, Grant says many patients will use traditional mascara or one of the more recent commercially available products like LashDip. LashDip is a waterproof chemical that bonds to your natural lashes and can last up to six weeks.

As with all medicines there can be side affects that you should be aware of before you begin using the product, so check with your doctor first. Grant says the vast majority of his patients are pleased with the results from Latisse and have seen a dramatic improvement in the length and number of their eyelashes.

What is  important to know for a patient who wants a facelift?

Dr. Bucky has extensively researched facial aging and has developed techniques that enhance natural appearances after cosmetic surgery. He says anyone considering a facelift needs to understand how your skin changes with age, and “the keys to an excellent facelift are understanding the [following] three components and treating them individually.”
The first change is a loss of elasticity to the skin. Elasticity problems need to be treated with things that improve elasticity; dermabrasion, peels or lasers.

Volume loss is a Key Problem a facelift needs to address

The second change is a loss of volume or deflation.  Bucky says, “Deflation problems need to be treated with things that improve volume, typically your own fat or sometimes other fillers.”

When deflation happens everything starts to drop and that leads to third change, gravitational descent.  According to Bucky, “Gravitational descent is the third component in aging and needs to be treated with a lifting procedure, some sort of anti-gravity approach.”

Dr. Bucky says, “When all three are performed appropriately, that usually ensures a good aesthetic result.” The final key is a quick and easy recovery.  “When all that is put together, you should come out with a result that looks refreshed, balanced, younger and not surgical.”

Plastic Surgery Channel facial expert Dr. Patrick  Sullivan commented,  “Facelifts when  performed properly can  result in some of the happiest patients;however, when patients are lured into procedures driven by marketing that  do not address all the facial aging components big issues are  often seen.”

As always, interested patients should ensure their surgeon is Board Certified by the American Board of Plastic Surgery when considering a facelift.

About The Plastic Surgery Channel

The Plastic Surgery Channel is a company devoted exclusively to educational programming about cosmetic and reconstructive surgery. Our goal is to provide credible, up-to-date information to people considering plastic surgery or a cosmetic procedure, as well as coverage of the latest news and hot topics from the field of plastic surgery.

Unlike shows you might see on network or cable television, the programming on The Plastic Surgery Channel does not strive to be sensationalist, focusing solely on extreme cases, nor is it solely devoted to a documentary-style overview of various medical procedures. Rather, we strive to inform — and in some cases entertain — viewers by providing relevant, engaging content that covers all facets of cosmetic and reconstructive surgery. We rely on experienced, board certified leaders in the field as content consultants, and conduct substantive research to verify the accuracy of the articles and videos that we present.

Of course, The Plastic Surgery Channel is not meant to replace the advice of medical professionals. Viewers are reminded to always consult a medical professional before making any decisions about plastic surgery or any other form of surgery.

For more information about our programming and our faculty, please email us at info@theplasticsurgerychannel.com

Laser skin resurfacing is an excellent way to reduce wrinkles and improve skin tone, but it comes with a downside. The complete destruction of the outer layer of skin means a swelling and a reddish complexion that can last for weeks. With fractional lasers, however, patients experience less downtime and an expedited recovery, says Dr. Brett Snyder, a board certified plastic surgeon practicing in Ponte Vedra Beach, Florida.

Laser skin resurfacing isn’t about burning off the top layer of skin, explains Dr. Snyder, although it’s a common misconception.

“A lot of people think, ‘Oh you’re burning the skin.’ You’re not burning the skin, you’re ablading it,” he says. Ablading is one way to jump-start the healing process, which results in collagen reorganization. That is what brings about the improved tone and texture.

Fractional lasers do this same process in less time because instead of taking out the entire layer of skin, you “blade” just small columns–or fractions–of it. That makes the same end result, but less healing time because there is less damage to heal. “The reason the recovery time is so much less,” says Dr. Snyder, “is usually because within a few hours of a treatment, those little holes have swollen shut.” From there, recovery occurs in just a few days, as opposed to weeks.

Early fractional lasers produced modest results compared to resurfacing lasers. Today’s fractional treatments require more downtime than the earlier ones, but have more significant results. However, he says, that is just a fact of life.

Notes Dr. Snyder, “If you are going to do something to the skin that is going to have significant positive benefit, the unfortunate truth isyou don’t get something for nothing.” Today’s fractional laser treatments still require less recovery time than traditional resurfacing

Approved by the FDA in September 2009, Ulthera is sweeping the nation as the newest non-invasive facelift technology.

Ulthera works through focused ultrasound. Focused ultrasound allows doctors to look deep inside the skin and treat areas without surgery. “We can actually see the layers, the skin, the fat, the muscle,” says Dr. Barry DiBernardo. “And then we target the muscle layer that we pull in a face lift, and it locks in on that layers and fires little pulses which tighten and shrink that layer.”

It works the same as a facelift in that when doctors lift the bow, cheek or jowl line, they are targeting the muscle layer under the skin–not the skin itself–and pulling it tight. “[Ulthera] targets that layer which we would otherwise do in a face lift, and tighten it with no downtime, no anesthesia.”  Ultrasound accomplishes the same thing by targeting that muscle but acting through the skin to shrink the muscle and draw it tighter. Article continues below video player.

This procedure works best for patients with the beginning signs of aging, not those who have lots of excess skin and muscle. “Those who are not that bad, who are starting to have loose structures, who have the jawline diminished,” says Dr. DiBernardo. “Those would be very good candidates, and they like the fact that they don’t need surgery.”

The jowl – that area in the lower cheek that can become fleshy or sag with time – is a tell-tale sign of age as it starts to droop…and a major target for people who want to turn back their facial clocks.

“They’ll say, ‘I don’t mind being 50 or 45, but I don’t want to be 45 with jowls,’” explains Rhode Island plastic surgeon Dr. Patrick Sullivan.

If the surgeon doesn’t take sufficient caution, however, a patient can undergo a jowl operation and walk away with scars. Sullivan cited a woman in her late forties who came to him in hopes of undoing the damage done by an apparently unqualified surgeon that left her with permanent scars on her face and neck.

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“What you have to do is make sure that you have a very good surgeon to take care of a problem like this,” he says.

As people age, the jowl areas can deflate and make their chin look bigger. Jowls can be removed or contoured, and Dr. Sullivan performs many operations that are lifting procedures done in layers rather than simply a quick stretching of the skin. Also, to provide a smooth jaw line after the lift, surgeons can employ a fat grafting procedure, using the patient’s own fat tissue from another nearby area to contour the mandible area.

“We give them a nice jaw line with their own fat rather than…something synthetic,” he says. Dr. Sullivan adds that using the patient’s own fat reduces the chance of infection and greatly increases the likelihood that the transplanted tissue will survive. At the same time, to produce the desired final result may require liposuction to get rid of excess fat.

In our image-conscious world, the natural aging process can be a cause of anxiety. From fine lines around the eyes to deeper creases around the mouth and lips, or the telltale “11″ left by a frequently furrowed brow, our faces leave tell-tale signs of the joys and challenges experienced in years gone by — signs we’d often prefer the rest of the world didn’t see.

“Every patient comes with a different complaint,” says Dr. Haideh Hirmand, a plastic surgeon based in New York City, who frequently sees patients wanting to turn back the hands of time. The answer, in many cases, is to use the newest generation of soft tissue fillers to minimize wrinkles and laugh lines, and restore volume to the face.

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Dr. Hirmand joined host Dr. William P. Adams, Jr. and fellow guest Dr. Christopher Inglefield, a prominent UK plastic surgeon, for a special episode of Plastic Surgery Talk taped at the 2009 annual meeting of the American Society of Plastic Surgeons to discuss the growing popularity of soft tissue fillers.

As we age, the body cuts down on the amount of fat in the face, notes Dr. Hirmand, making fillers an excellent option for restoring a youthful look.

Facial fillers are products injected into areas on the face to give that area more volume. Numerous kinds are available on the market, from collagen-based fillers to silicone to hyaluronic acid gels, and each has its place, depending on a patient’s needs and desired outcomes. The most popular brand names include Juvederm, Restylane, Perlane and Prevelle Silk.

“Every decade the body adjusts, and we preferentially lose fat in our faces,” she said. By using fillers, surgeons can fill in marionette lines around the mouth, crows feet, thinning lips, and hollows around the eyes to make a patient appear younger, well-rested and refreshed.

In the UK, another filler, called Macrolane, is now being used not only on the face, but also for small breast augmentations.

“It’s for a woman who wants one cup size, one-and-a-half cup size increase,” explains Dr. Inglefield. “It is done under local anesthesia on an outpatient basis, as a sort of walk in, walk out procedure.”

Although the use of Macrolane fillers for breast augmentation is gaining popularity oversees, the product has not been approved in the U.S. to increase breast size, and the long-term results are still unknown.

This episode of Plastic Surgery Talk is sponsored by Mentor. Learn more about Memory Gel breast implants at LoveYourLook.com.

People experience discoloration on the skin of their faces and hands for a variety of reasons, including hormonal changes, sun damage, surgical procedures, and even pregnancy.

In the past, treatments for this condition included intense pulsed light therapy and hydroquinone, an effective topical cream that produced reliable results. However, hydroquinone also has a variety of side effects, including itching and burning.

But, says Dr. Bryan Forley, some new products, such as Lumixyl, promise results just as effective, without skin irritation.

“The beauty of the product is that it’s very safe, it’s very effective, and it’s very well-tolerated by all skin types,” says Dr. Forley of Lumixyl, which was developed by researchers at Stanford University.

Lumixyl can also be used to prevent skin pigmentation problems as well, when used prior to surgical procedures in which the body’s natural healing response might be to produce excess pigment. “If you pre-treat the patient, and then continue to treat them afterwards, then you can oftentimes lessen or completely avoid the pigmentation issues,” says Dr. Forley.

Lumixyl is a topical cream applied twice a day, and with everyday use most patients should see results within about eight weeks, but can be used for longer periods of time.

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Botox is safe and effective – but also temporary. Many patients wonder why the results can’t be more permanent.

“Botox binds to nerve endings, preventing communication between the nerve and the muscle,” explains Dr. Brett Snyder, a board certified plastic surgeon in Ponte Vedra, Florida. He adds that once this happens, the patient can’t contract that muscle. Consequently, after a Botox injection, the frown and smile muscles in the forehead and eye area can be prevented from moving – and from creating lines and wrinkles.

But, the effects are always temporary. This is because the nerve endings eventually grow new endings and sprout around the “blockade” of Botox and communicate once again with the muscles. And, ultimately, the lines and wrinkles come back. It generally happens a few months after the Botox injection.

“Even if it’s used to excess, it’s going to wear off,” Dr. Snyder says.

Botox Comsetic is actually a highly purified form of botulinum toxin type A, which many people have confused with botulism. Dr. Snyder admits the term “neurotoxin” is misleading, as if it is damaging to nerve cells, but that isn’t how it works. Botox was first used by Dr. Alan B. Scott in the 1980s as a way of treating eyelid spasms, a rare condition. These patients have had a high success rate – as have children who receive high doses of Botox as a treatment for spastic muscles.

Dr. Snyder notes that patients who use Botox for cosmetic reasons tend to get longer lasting results out of their injections if they have been using it for a long period of time. Muscles injected with neurotoxins tend to atrophy over time, causing a lesser need for additional treatments. Some patients eventually need to use it less frequently to get the same effect.