Archive for the ‘Cheek Augmentation’ Category

Dr Young’s ideas on Singer Charice and her quests to change her look through Plastic Surgery (Bellevue, Washington)

Thursday, July 29th, 2010

Charice is a wonderful singer as I have seen her perform on Oprah.  Recently, there has been information on her seeking the advice from plastic surgeons.  What has been talked about is her recent use of botox for her episode on Glee.  Botox is great for younger people to keep the wrinkles at bay.  Especially when they get nervous and start to create alot of wrinkles in their forehead, in between their eyes and crows feet.  In can give people the impression that they are more relaxed than what is really going on inside.  Many times when people get nervous they may lose their sense of how they are appearing.  They crunch their eyebrows and it makes them look mean.  They raise their eyebrows when they get nervous and you can tell they are nervous.  Botox comes all of those things down and you look better, more relaxed, and not as nervous.

She also is inquiring about make her face less round and what she can do to make her self look better.  I did an analysis on her based on my theory on facial aesthetics.  Although her face is tilted.  In general what the diagonal lines are showing you is that her cheeks and lower cheek areas are really dominate.  The middle oblique, and the vertial line is where the shadowing should be increasing markedly as it you go from lateral and inferiorly.  But  you see in the picture that her cheeks still are showing a lot of highlight in this area.  This is seen in the first figure.  The second are before and afters of my morphing to show you how she would look with some jaw and cheek reduction surgery and rhinoplasty.  I think she could look a lot better by narrowing her face and also making her nose a little smaller in the tip area.  She might also need some mesotherapy or microliposuction in her cheeks.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Cheek implants are another option for volumizing the cheek and middle part of the face

Thursday, June 10th, 2010

Cheek implants (Philip Young MD of Seattle / Bellevue WA) are another option for volumizing the cheek and middle part of the face.  Some plastic surgeons believe that volumizing the face is the most natural way to rejuvenate the face.  Fat injections are very popular and in the right hands can lead to great long term results.  One of the drawbacks with fat injections are the variable results with survival.  It is not reliably known how much fat can survive and this is also dependent on the particular person.  One option to volumize the face is the use of implants.  Silicone and medpor / porous polyethylene are great implants.  Medpor implants are great because they allow vascular in growth and after 12 weeks these implants are very resilient.  Some studies have shown that skin can grow over these implants after the 12 weeks of vascularization.  This is amazing to me.  That is one of the many reasons why I like Medpor / Porous Polyethylene implants.   Many people believe that cheek implants and other facial implants are good to replicate the hard bony contours of the face and that fat can soften the facial features.  People believe that volumizing the face should entail both facial implants and fat injections.  In this video, I demonstrate the use of an inferior orbital rim implant, cheek implant and paranasal implant.  The inferior orbital rim implant is good to improve the hollows of the lower eyelid area.  The cheek implant is good for recreating the volume in the cheeks or creating new volume that a person never had.  Cheek implants help improve nasolabial folds, pull up jowls and the middle part of the face.  Paranasal implants are good to improve the nasolabial folds, and volumize the sunken middle part of the face and make the middle part of the face standout more.  This implant is great for people who have binder’s syndrome, or sunken middle faces as well.

Thanks for reading,

Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Perinasal implants for sunken cheeks and nasolabial folds

Saturday, May 8th, 2010

One overlooked solution to sunken cheeks and nasolabial folds are perinasal implants (Dr Young specializes only in the face and neck and is located in Bellevue Washington) that you can insert next to the nose.  A lot of what creates nasolabial folds is the volume loss in the cheek next to the nose.  This can be a natural occurence for people or can result from aging.  A perinasal implant are most commonly silicone and medpor.  They can be inserted from the nose along the floor or within the mouth through really small incisions. The other to do this is through fat injections or the YoungVolumizer which I developed.  All options serve to plump up the perinasal area to decrease the nasolabial fold deep characteristic.  For the nasolabial folds you may also need some superficial volumization through fillers.  The perinasal implant can also volumize this area to give the medial cheek more prominence.  This tends to highlight the central face where you want the most attention.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

I have acne scars and was wondering if a minilift could help. I also have hollow under eye areas, and cheek hollowing. Is fat grafting a good option for my lower eyes and cheeks?

Thursday, May 6th, 2010

A minilift (Dr Young has extensive experience in facelifts and has done over 1200 facelifts and is located in Bellevue, WA) could help remove some extra skin and Fat injections are great for the Hollows under  the Eyes.  I have many patients that I have done a minilift for acne scars.  My patients seem very pleased with the results for this reason. It is not a common application for a minilift to improve acne scars but some people find it very useful.  Fat injectons under the eyes are a great way to improve the volume loss there and the dark circles, and baggy look in this area.  Fillers can also be done here as a temporary measure.  Fat injections, if all variables are positive, can last years in this area.  Volumizing in this area is the most natural and, in my opinion, is better than any type of lower eyelid lift or cheek lift.  Fat injections are also great for acne.  A thin layer under a bed of acne scars will improve their appearance, rejuvenate the skin and elevate some depressed scars to a degree.  I think volumizing your whole cheek could really help your appearance.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Fillers and Fat injections for Cheek Augmentation

Tuesday, February 23rd, 2010

Radiese and Sculptra (dermal fillers, restylane, juvederm, perlane / Dr Young Bellevue) can both be used in the cheek area.  They have different qualities that should be considered by each patient and from that you can understand for each patient which product is better.

Radiesse is made of Calcium Hydroxyapatite which is the exact molecule that is like our bones except without the cells and other tissues like collagen, blood vessels etc.  It is very compatible with our bodies.  Studies done by Radiesse have shown that this product is replaced a little bit by collagen.  Radiesse has been shown to be present after 5 years by biopsy and some of this work has been done in the area of urology and the bladder neck.  It is a stiffer products than the other fillers like restylane, and sculptra.  The product is made up of 30% calcium hydroxyapatite so the rest of the 70% is removed over the first 6 months to a year and the 30% can stay around longer.  Some people seem to metabolize the calcium more quickly and this can decrease the longevity, although this is through my observation and has no scientific analysis to it yet.

Sculptra is made up of poly l lactic acid and is like vicryl suture which is degraded by our body to water and sugar which we can use.  The degradation process is what produces the inflammation that eventually creates collagen, in a controlled scar like fashion.  Results are for at least 2 years and they are finding that it lasts even longer in many instances.  I have a patients whose results have been there for over 5 years.  This inflammation is beneficial in that it produces collagen but on the flip side this inflammation when not controlled can lead to infection although this is very rare.  Although most of the doctors mention bumps, this can be avoided.  I have some techniques that make this much less likely.

Fat injections are a great longer term option.  They are natural. They take on the structure and feel of the tissue they are placed next to.  If they are placed next to bone they will feel like bone and etc.  They can last years, although this depends on the particular person, some results can last 10 years or more. They require no incisions in the face, the discomfort is mucher lower than traditional approaches like facelifts, eyelifts.  They do require a recovery period from the bruising and swelling but is acceptable.  Unlike sculptra and radiesse, fat can be placed closer to the eyelid and lashes.  Whereas these products need to be along the bone under the eye and this is where you can some problems with transitioning the volume from the bone to the eyelid whereas fat can do this transition. You can read my blog for more information.

In terms of transitioning the product to the eyelid wiith radiesse and sculptra, the other alternative is to do transitioning and touchups with restylane, perlane or juvederm when needed. These hyaluronic acids (restylane, perlane, juvederm) can also be used for cheek augmentation but last less long (6 months to a year) than radiesse (year or longer) and sculptra (at least 2 years).

I hope that helps.

Thanks for reading, Dr Young

Dr Young specializes in Facial Cosmetic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Heidi Montag’s recent 10 procedures in one day topic

Tuesday, January 19th, 2010

Its big news that Heidi Montag had 10 procedures in one day.  In my opinion, that might be a little too much surgery in one day.  Although all of this information may be false. Who really knows but her and her doctor and the people in the room that day how many surgeries she really had.  I think based on looking at her pictures that she did appear to have had chin reduction, a rhinoplasty, possibly a browlift, and cheek enhancement.  Based on the pictures, I think she looks better before all of her procedures.  The chin reduction surgery has made her face actually look more square and more masculine. Although she mentions that she was teased as a child about her chin, I think the chin gave her lower face a pointier appearance which as an overall affect made her face appear more pear shaped.  Now that the chin is reduced, the face has lost the pear appearance and has been squared off like many male faces.  Her changes in her nose, possibly due to a rhinoplasty, has actually lengthed the appearance of the middle part of her face.  With that change, her face looks longer and less proportionate.  the distance between her eyes, nasal tip and lower lip should all be separated by equal distances and ideally 3 iris widths.  Her nose looks longer and I think her face has loss some beauty points. I think she might have also has her cheeks augmented.  This appears to have made her cheeks look wider.  I think that has also masculinized her face.  The cheek augmentation should have been more anteriorly closer to the eye and just outside (or lateral to) the eye.  The browlift, if it was done, is questionably needed at best.

When I see patients that request things that I don’t think needs to be done, I will tell them exactly what I think.  If I feel strongly enough, I refuse service to them.  If the procedure they are requesting is not consistent with my beliefs of what would enhance their aesthetics, it takes a lot of influencing for me to do what they request.  Although, I always have to balance my aesthetic beliefs with the desire of the patients.  Ultimately, what the patients wants is still very important.  But I have a long discussion with them if their desires are quite different then what I think will help them.

Thanks for reading, Dr Young

Dr Young specializes in Facial Cosmetic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

What are some options for filling in dents in the cheek?

Tuesday, September 15th, 2009

Fillers, the YoungLift, Fat Injections, Cheek Implants are options for those areas.  Having experience in augmenting areas such as this is important.  Fillers are temporary (restylane, juvederm, perlane, cosmoderm) but can be a way to fill in those dents and a good way to assess whether volume can help.  Fat injections are a long term possibility to augment that area.  If the fat survives after 6 months it is likely to last for years.

I refined an amazing volumizing procedure called “the YoungLift”. This is an innovative technique that volumizes your face to bring out the younger and natural you without looking like you had something done. This is not a facelift and requires no incisions. Only pinpoint puncture sites are used and these heal imperceptibly. The YoungLift can be done without general anesthesia and without drains, and large bandages. You also have sometimes a lot less downtime and discomfort compared with traditional facelift procedures. I employ the very best techniques from around the world into one volumizing procedure and I use my internationally acclaimed understanding of facial beauty to create the youthful volume you once had. In your case, the Younglift could help fill in the dents that you are concerned about.

Cheek implants (cheek augmentation / cheek lift / cheek filling / cheek enhancement) are another way of augmenting the cheek but in your case would not be a good option.  Your dent is mostly a superficial element and would require something placed in a superficial manner.

Thanks for reading, Dr Young

Dr Young specializes in Facial Cosmetic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

What are the options for sunken cheeks besides temporary dermal fillers?

Wednesday, August 5th, 2009

This is a questions I answered for someone that was wondering what option there were for sunken cheeks besides temporary dermal fillers. Fat injections or silicone implants can give you the long term volume you desire in the cheek.

Sunken cheeks is a natural aging process.  When you age you lose fat in your cheeks and this can lead to your tissues descending, wrinkles developing, folds developing, lower eyelid fat protruding, eyelid bags, etc.  Dermal fillers like restylane, juvederm, radiesse, perlane, are temporary and last from 6 months to a year or more.  Of these fillers radiesse is a bone product made up of calcium hydroxyapatite while the others are made up of hyuloronic acid.  There are more permanent fillers like silicone injections, and artefill.  The problem with permanent fillers is that they have the potential to cause infections, scarring and granulomas (balls of chronic infection) that can present years later after you think everything is okay.

Other more permanent options for sunken cheeks include fat injections and silicone implants.  Silicone is very compatible to place in the cheeks.  The silicone atom is one step below carbon on the atomic chart and hence makes it really compatible.  The infection rate with silicone is very low and its use has a long history of safety.  Silicone implants can be placed within the cheek to give a person a more permanent volumizing and lift up sunken cheeks.

Fat injections are another way of volumizing the cheek. Perrmanency depends on whether the fat survives.  This depends on many factors: technique, health of the patient, care of the patient after the procedure, etc.  If fat lasts for more than 6 months to a year, it will likely survive for many years sometimes 10-15 years or longer.

I refined an amazing volumizing procedure called “the YoungLift”. This is an innovative technique that volumizes your face to bring out the younger and natural you without looking like you had something done. This is not a facelift and requires no incisions. Only pinpoint puncture sites are used and these heal imperceptibly. The YoungLift can be done without general anesthesia and without drains, and large bandages. You also have a lot less downtime and discomfort compared with traditional facelift procedures. I employ the very best techniques from around the world into one volumizing procedure and I use my internationally acclaimed understanding of facial beauty to create the youthful volume you once had.

Dr Young is located in Bellevue near Seattle, Washington

Dark Circles, Jowls and whether a facelift of some sort can help

Thursday, July 16th, 2009

In terms of a facelift, you might be a little early to have one.  It would really be beneficial to see a picture of you without smiling. A facelift can lift your jowls and improve your nasolabial folds to some degree. it won’t help your dark circles, and bags under your eyes.  Most surgeons would advocate a lower eyelid blepharoplasty, but this could cause hollowing under your eyes and appear unnatural.  I would suggest filling your cheek and lower eyelid with some type of filler.  With filler you could go with temporary fillers or try the YoungLift.  Fillers such as Restylane, Juvederm, Radiesse, Perlane, can all fill in the cheeks and partially the lower eyelid but are temporary and last 6months to a year or more.  Permanent fillers such as silicone and artefill are risky and I stay away from them.  Fat injections can help and if the fat survives for more than 6 months to a year it will stay there for years sometimes more than 10 years.

I refined an amazing volumizing procedure called “the YoungLift”.  This is an innovative technique that volumizes your face to bring out the younger and natural you without looking like you had something done.  This is not a facelift and requires no incisions.  Only pinpoint puncture sites are used and these heal imperceptibly.  The YoungLift can be done without general anesthesia and without drains, and large bandages.  You also have a lot less downtime and discomfort compared with traditional facelift procedures.  I employ the very best techniques from around the world into one volumizing procedure and he uses his internationally acclaimed understanding of facial beauty to create the youthful volume you once had. The YoungLift techniques can help with filling up the lips as well.  You can great results with fat injections in the lips.

Dr Young is located in Bellevue near Seattle, Washington

Best treatment for tear trough: lasers, fillers, or fat injections?

Wednesday, July 15th, 2009

The tear trough is a tough area to treat through eye lifts / blepharoplasty procedures. This area is located between the nose and the lower eyelid and is situated not above the bone as most people believe but above the soft tissue of the eye socket and eyelid. People have tried repositioning of the eye socket fat into that area through a blepharoplasty / eyelift procedure.  This can work but has been shown to lead to eye position abnormalities and problems with dry eyes, etc. Fat grafting can work in this area and may be the most natural way to rejuvenate this area.  It does have some issues related to survival of the fat.  But is the fat survives past a year it will likely stay in the area for many years, sometimes 10-15 years.   Fat grafting requires a lot of skill and knowledge of fat survival techniques.  Fillers can fill up the volume loss that has lead to the tear trough appearance and I’ve done that many times and have a lot of patients that get this done.  The key is being able to fill up the area without leading to bumps and ridges.  This requires some skill and with a surgeon’s experience it can be done to look very nice and satisy your clients.  Fillers can look not as natural as fat, it can lead to a translucent type of appearance and some dark appearance of the filler within the skin.  But, in general >95% or more patients are very, very happy that they had filler placed to treat the tear trough area. Lasers can create a layer of collagen underneath the eyelid skin to camouflage the dark appearance of the muscle underneath the skin.  It can also tighten the skin and reduce the unwanted wrinkles in the lower eyelid.   However, lasers will not replace the volume that is lossed with aging around the lower eyelid area.  This is where fillers and fat injections come into play.

I refined an amazing volumizing procedure called “the YoungLift”.  This is an innovative technique that volumizes your face to bring out the younger and natural you without looking like you had something done.  This is not a facelift and requires no incisions.  Only pinpoint puncture sites are used and these heal imperceptibly.  The YoungLift can be done without general anesthesia and without drains, and large bandages.  You also have a lot less downtime and discomfort compared with traditional facelift procedures.  I employ the very best techniques from around the world into one volumizing procedure and he uses his internationally acclaimed understanding of facial beauty to create the youthful volume you once had. The YoungLift techniques can help with filling up the lips as well.  You can great results with fat injections in the lips.

Dr Young is located in Bellevue near Seattle, Washington