Archive for the ‘Fillers / Facial Fillers’ Category

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Botox is good for dynamic smile lines, filler and resurfacing can help static lines

Friday, September 17th, 2010

Restylane and Juvederm (or Perlane)  are both great options for filling and improving static lines and dynamic to a degree.  Ipl will, in my opinion, have little effect on the wrinkles. Glycolic peels can help to a minimal degree on fine lines and improving your general skin appearance. Resurfacing is another way to improve your wrinkles on your face by approaching from the outer skin side.  Whereas fillers approach the wrinkles from inside.

Botox is good for dynamic smile and facial  lines, in contrast filler and resurfacing can help static lines. Botox is a neuromuscular agent that blocks the action of muscles by acting on the nerves that innervate muscles.  The way you can tell if botox will work for you is to identify whether your smile lines or wrinkles are accentuated or increased by the act of smiling or the muscles that move your face when you smile.  Botox is good for the wrinkles that increase in appearance with muscle movement.  If it is the wrinkles that are present when you are not moving a part of the face, botox will have less of an effect.  But botox will have an effect on those wrinkles getting deeper when you move your face.  But when your face is at rest the wrinkles that are there will not noticeably improve with botox.  One thing to realize is that if you use botox for a long time, your static wrinkles can improve but this takes a while.  Your cells in your skin have to remodel your skin where the static wrinkles are in order to improve those wrinkles which could take months and years.  Part of what makes wrinkles deeper are the the loss of volume within your face.  This places the skin closer to your muscles and thus when you move your muscles to smile or talk, there actions begin to have more effect on your skin and the effects are wrinkles with the movement.  The volume loss can help this situation by increasing the distance of your skin to your facial muscles.  Fillers are a temporary solution (anywhere from 6 months to a year) and Fat injections are more of a long term solution.  The YoungVolumizer is a great way to volumize your face in a natural way with no incisions, and no general anesthesia.

Thanks for reading, Dr Young

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

Posted in Botox, Dysport, Botulinum, Fat Transfer / Fat Injections, Fillers / Facial Fillers, Juvederm, Restylane, YoungVolumizer | Comments Off on Botox is good for dynamic smile lines, filler and resurfacing can help static lines

Fat transfer from an animal, can that be done and also can it be done by a nurse at her house?

Tuesday, August 24th, 2010

This is a response to a question that I answered for a person who had a procedure by someone else:

Fat transfer from an animal is not something that sounds legal and is not a sound principle. Given that it was done at a nurse’s house sounds extremely fishy to me. That in itself is not legal unless she has established her home as a place to business and is certified to do these procedures.  To begin with RN’s aren’t supposed to inject fat in the first place. Fat from an animal will also be completely degraded by a person’s body and any results are likely due to scarring.

Thanks for reading, Dr Young

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

Posted in Fat Transfer / Fat Injections, Fillers / Facial Fillers, YoungVolumizer | Comments Off on Fat transfer from an animal, can that be done and also can it be done by a nurse at her house?

How do I prepare for a filler and what kind of post care should I think of after a filler?

Friday, July 23rd, 2010

Fillers (Dr Young from Aesthetic Facial Plastic Surgery, PLLC in Bellevue, WA) are products that are used to volumize your face.  As you age, you lose volume in your face and these fillers replace this volume.  The most common fillers include restylane, radiesse, juvederm, and perlane.  These are the top four products being used.  So what are some of the things you should be thinking about with filler.  Well to begin with you should not be allergic to any of the products including hyaluronic acid, calcium hydroxyapatite, carboxymethocellulose, gram positive bacteria especially streptococcus, lidocaine or amide type local anesthetics, or a history of multiple allergies or severe reactions to certain medications.  I usually tell people to refrain from high dose vitamin E, herbal medications, supplements, fish oils, omega 3’s, anti-inflammatories (naproxen, aleve, ibuprofen, advil, indomethacin, motrin, excedrin, piroxicam, sulindac, etc.), aspirin 2 weeks before and after the procedure included with this list are some obvious ones like warfarin, coumadin, heparin, lovenox, plavix. Here is a more formal list of medications to avoid from our website.  I do this because these elements / medications can cause bleeding and if you avoid these during this time frame you can avoid extra bruising and swelling.  Arnica and bromelein have shown some benefits but are still being studied and are not a standard in treatment for plastic surgeons so I don’t really recommend it.   This pre filler care will help with the post care.  You should discuss during your consultation the risks and benefits of the use of restylane. During the filler you will have some choices for the type of anesthesia you can get for the filler injections. Now most fillers have lidocaine in the preparation to make it more tolerable.  These are the options:

1. Use ice then inject. Can work but by numbing the area with the ice.  With the local in the filler, you may feel it go in initially with each stick in any new area. But subsequent injections will be more numb with the anesthesia in the filler itself

2. Use topical anesthesia first and then inject.  This is a good option.  The topical makes the skin numb, you may feel the injection go into the deeper layers. But like ice, it will feel like a stick in the new area and then get better with subsequent injections.

3. Local anesthesia and regional anesthesia, so called “dental blocks” to numb the nerves that innervate specific regions.  This is the best way to make it so that you don’t feel anything.  For some it is over doing the anesthesia.  Sometimes, people who get anxious can get reactions to the local anesthesia and you can get an anxiety situation where your heart rate goes up as well as your blood pressure.  This happens about 1 out of 25o times a filler gets done with local / regional anesthesia.

After the filler, you should ice the area especially for the first 48 hours.  I usually suggest 10 minutes for every hour.  I also stress that you should not have the ice directly on the skin but have a barrier to prevent damage to your skin.  This icing will keep the swelling down and also the bruising to a degree.

For the first two weeks, I usually suggest people to massage the area of the filler if there are certain areas that are more elevated and pronounced than the other areas.  Most of this uneveness if it is present will be improved with this.  When the filler is in the lower eyelid area, you need to pull down the swelling over the bone and then massage it from there to effect it.  After the first two weeks, I then suggest to consider more massage if the elevations are subtle and if large then you can consider enzyme injections or hyaluronidase injections which are very potent in reducing unwanted swelling from filler.  Now with radiesse there is no enzyme that will do the same and you have to just massage the area to make it go down to a point that you like.

If you have any questions you can always email me or ask me through this blog

Thanks for reading, Dr Young

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

Posted in Fillers / Facial Fillers, Juvederm, Perlane, Radiesse, Restylane, Uncategorized | Comments Off on How do I prepare for a filler and what kind of post care should I think of after a filler?

Can fillers like restylane cause blindness if injected into the tear trough?

Wednesday, July 14th, 2010

Fillers (like restylane, perlane, radiesse, juvederm by Dr Young in Bellevue near Seattle, WA) in the tear trough can theoretically lead to blindness but there are precautions that you can take to prevent it.  The veins around your eyes and nose and center of the face are valveless and do not prevent particles from traveling back into the deeper tissues like your eyes and brain.  It is possible to cause the particles that are injected with fillers to go back into the eye to cause blindness.  But this is extremely rare.  You can take some precautions to prevent this though.  When you inject, you should not apply to much pressure with injecting.  Also when you inject it you should never be in one place and your needle should always be moving and distributing the filler evenly.  This prevents a load of filler being place in one spot and in the case that you are near a vessel the one spot is not being filler aggressively and possibly back into deeper structures like your eye. Also local anesthesia prevents the vessels from being injected by constricting the vessels so that it is less likely for the filler to get into the vessels. This is a video on fillers around the eyes.

Thanks for reading, Dr Young

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

Posted in Blepharoplasty / Eyelift / Eye Lift / Dark Circles / Eye Bags, Fillers / Facial Fillers, Juvederm, Perlane, Radiesse, Restylane | Comments Off on Can fillers like restylane cause blindness if injected into the tear trough?

What can make the tip of my nose smaller? What are the options?

Friday, July 2nd, 2010

Temporary Fillers can be an option. Rhinoplasty limited to the tip is a more permanent option for your pointy nose. Your case is a prime example that making a nose smaller is not always the best option to making a nose more attractive.  I discovered a theory which I won an award for that explains why this is.  Your nasal tip should be the approximate size of the colored part of your eye, called the iris.   Fillers could fill around your nasal tip and make it looker larger to decrease the pointy sensation and appearance of your nasal tip.  This is temporary. I would suggest restylane as the best option and this would last from 6 months to a year.  A tip rhinoplasty can improve this as well.  I would sculpt cartilage to increase the size in a subtle way to improve the tips appearance.  This is usually done through an incision at the bottom of your nose that hides really well.  Recovery from a tip rhinoplasty is longer than for a temporary filler. Here is a video of myself doing a tip rhinoplasty.

Thanks for reading, Dr Young

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

Posted in Fillers / Facial Fillers, Rhinoplasty / Nose Surgery / Nose job / Nose Reshaping / Nasal Reshaping | Comments Off on What can make the tip of my nose smaller? What are the options?

Does Restylane lead to collagen production?

Wednesday, June 30th, 2010

Restylane has not shown to produce collagen in studies. But in my experience, I have seen persistent correction of people for longer than what is advertised.  The thought of what process is going on is that there seems to be scar tissue that is forming around the restylane that prevents is degradation.  This is not an uncommon thing that I have noticed in my practice.  I would say that I have seen this in about 5 % of my patient population where they get much longer acting results from restylane injections.  With the manipulation of the needle and the subsequent bruising, I believe that some collagen production is possible but not consistent in my experience.

Thanks for reading, Dr Young

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

Posted in Fillers / Facial Fillers | Comments Off on Does Restylane lead to collagen production?

A Mini Facelift for Acne Scars by Dr. Philip Young of Bellevue | Seattle:

Thursday, May 6th, 2010

A Mini Facelift for Acne Scars by of Bellevue | Seattle: A minilift (Dr Young has extensive experience in facelift and has done over 1200 facelift 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

Posted in Blepharoplasty / Eyelift / Eye Lift / Dark Circles / Eye Bags, Cheek Augmentation, Facelift / Face Lift / S lift / Mini Lift / Weekend Face Lift / Quick Lift / Image Lift, Fat Transfer / Fat Injections, Fillers / Facial Fillers, YoungVolumizer | Comments Off on A Mini Facelift for Acne Scars by Dr. Philip Young of Bellevue | Seattle:

I have a line on my cheek and I was wondering what kind of cheek lift or filler I can use.

Thursday, May 6th, 2010

You can inject both Restylane or Juvederm (Dr Young is a filler expert in Bellevue Washington)in your cheeks.  They are both very safe when injected by someone with experience.  There are some differences in both of them.  Restylane has been approved for 6 month duration and juvederm for 9 months.  I think they are about the same in terms of length of duration in my experience ranging from 6 months to a year.  One thing to realize is the Restylane comes in 1.1 milliliters or cc’s and Juvederm comes in about 0.8-0.9 ml or cc’s.  You get a little more restylane than juvederm.  Some people think that Juvederm is smoother and results in less lumps but I think that hasn’t been the case for me.  The great thing about Juvederm, Restylane, Perlane is that you can mold these products a bit and if after 2 weeks you have some augmentation that you don’t like you can always inject some enzymes into the areas to decrease the amount of augmentation to get the very best results.

Thanks for reading, Dr Young

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

Posted in Fillers / Facial Fillers, Juvederm, Perlane, Radiesse, Restylane | Comments Off on I have a line on my cheek and I was wondering what kind of cheek lift or filler I can use.

Can you inject botox and filler at the same time in the same area?

Thursday, May 6th, 2010

Injecting botox first and then to follow it immediately with a filler (Dr Young in Bellevue Washington) can risk problems with moving the botox around.  There is not sufficient scientific evidence documenting the safety of both at the same time.  It is not widely accepted.  If the botox and restylane are used in different places then it is more okay and accepted in my opinion.  I like assessing the results of the botox first and determining if the results of the botox is achieving the results that you or the client likes.  If more results are desired then you can consider the filler 2 weeks later.  This also allows the filler to stay longer because the muscles are not causing the dispersement of the filler and also the metabolism of the filler to be increased.

Thanks for reading, Dr Young

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

Posted in Botox, Dysport, Botulinum, Fillers / Facial Fillers | Comments Off on Can you inject botox and filler at the same time in the same area?

How many syringes do people use for certain areas on average when it comes to fillers in the face?

Tuesday, April 20th, 2010

There is no real standard for fillers (Aesthetic Facial Plastic Surgery, Dr Young Bellevue) in certain areas but a general idea is out there.  One thing to realize is that everybody is different.  But in general, for example, in the lips I usually start out with one syringe of restylane or juvederm.  For the nasolabial folds, I usually use at least two syringes of either one.  For the cheeks you can 2-4 syringes.  For the under eye area along the inferior orbital rim, I use one on each side to improve the hollows. For the upper eyes and the hollowing there I use 1-2 total.  For the marionette lines under the lateral part of the lips I will use 1-2 syringes.  The syringes range from 500-700 per syringe on average.  There are some reductions the more you do for most offices. Instead of fillers, options that I think are great include fat injections, or the YoungVolumizer which I developed.  With these options you can globally volumize the face and given a general rejuvenation.

Thanks for reading, Dr Young

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

Posted in Fillers / Facial Fillers, YoungVolumizer | Comments Off on How many syringes do people use for certain areas on average when it comes to fillers in the face?

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