Archive for the ‘Restylane’ Category

What is the best treatment for laugh lines? Fillers or Botox?

Monday, February 22nd, 2010

Juvederm is commonly used for laughl lines as well as botox.  It is important to know what you mean by laugh lines.  Many refer to these as the lines around the eyes, or crows feet.  Others mean when the say “laugh lines”, the lines around their mouths or nasolabial folds.  I have a blog that defines those areas if you are interested to know the terms.  But the nasolabial folds are the folds that run from the nose along the sides of the mouth. Whereas the lines below the mouth on the sides are commonly refered to as the marionette lines or puppet lines.  The crows feet can be improved by botox and they can also improve the nasolabial folds to some extent.    Fillers like juvederm can also fill in the nasolabial folds, marionette lines and also help with the crows feet.  In order to really understand how they work a visit to a facial plastic surgeon would be helpful.  Now the difference between fillers and botox is that fillers replace volume that is lossed during aging.  When you lose volume there is an excess amount of skin compared to the underlying tissues.  More skin for a set amount of volume leads to more folding of the skin and hence more wrinkles.  Fillers replace that volume and hence fill in the skin and thereby decrease the ability for the face to make wrinkles.  Botox, which is a neuromuscular agent can make the muscles less likely to contract.  Hence they are most beneficial for dynamic wrinkles, or the wrinkles that are caused by muscular activity.

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

Can hyaluronidase leave scars, holes? Does the enzyme break down a persons own acids and what affects are there?

Monday, January 25th, 2010

Facial Fillers is an enzyme that breaks down hyaluronic acid such as fillers used for cosmetic purposes like restylane, juvederm, perlane, etc.  It doesn’t seem to affect natural hyaluronic acid and has a predominate affect on filler injected.  The reason for this is due to the fact that natural hyaluronic acid is found around a substructure within the skin.  When natural hyaluronic acid is degraded it is reformed almost just as quickly.  In fact, natural hyaluronic acid is turned over on a daily basis so your body naturally degrades its own hyaluronic acid and replaces.  With your natural foundation, the hyaluronic acid is formed all the time so the enzyme injected and its effects will be reversed quickly.  It does not leave scars or holes,  except in the area of previous filler injections.  You have to be conservative in the amount that you use otherwise you can get depressed areas in the previous area that you augmented.  That is the only temporary risk.  Some suggest a skin test for the enzyme in case of an allergic reaction.  But I know of hundreds to thousands of patients who ht tave received this in surgery centers with no issues at all.

Thanks for reading, Dr Young

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

lumps and bumps 3-4 days after lip augmentation with Restylane

Monday, December 7th, 2009

The swelling in the lips usually takes a while to go down after Lip Augmentation (lip filler, lip enhancement, lip plumper, younger lips, lip injectibles) with Facial Fillers. Your lips are very vascular and with that comes easier bruising and swelling. 3-4 days is on the early side. I usually wait for the first 2 weeks for the swelling to go down.  During these first 2 weeks is when massage can really help dissipate the swelling.  Enzyme injections are also another way of removing restylane, juvederm, perlane but they are more of a permanent removal of the restylane.  If enzymes are injected during the first 2 weeks, this may be a mistake.  The swelling that would normally go down the first 2 weeks will further go down more if enzymes are injected the first 2 weeks.  Sometimes waiting at least 3 weeks is even better.  One thing to remember is that restylane and other hyaluronic acid fillers can be shaped though and you shouldn’t have to go through 6-9 months of a less than desirable result.  Enzyme’s can help shape your results after 2-3 weeks.  Notice how in the example that the lower lip in the after maintains the size that is 2 times greater than the upper lip.  From the viewer standpoint, it doesn’t look wierd to them.

Thanks for reading!

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

Before Restylane Injections / Lip augmentation

Before Restylane Injections / Lip augmentation

After Restylane Injections / Lip augmentation

After Restylane Injections / Lip augmentation

Fillers, Botox or Lasers for the Under Lower Eyelid Area?

Thursday, October 15th, 2009

This was a question I answered for someone recently:

Restylane is a filler and can be used to fill in the lost volume that is really the cause of the majority of the reason why your lower eyelid looks the way it does. Fat injections, the YoungLift, Juvederm, Perlane, Radiesse are other fillers that can be filled into the lower eyelid area.  The temporary fillers last from 6 months (restylane) to a year or more (radiesse) with perlane and juvederm in between.  Fat injections can last much longer but this isn’t guaranteed but is the best shot for a long term correction.

Botox prevents the muscle around the eyes from squinting which can make the wrinkles less noticeable. Dysport (or botox / bo tox / botulinum / neurotoxin / disport) is a great option.  But these do nothing for the surface quality of the skin and neither does the filler. But the fillers can decrease the amount of wrinkles by filling up the volume.

This is where the co2 laser or other resurfacing procedure (erbium yag, active fx, ultrapulse, deep fx, max fx, total fx, traditional co2 laser resurfacing, laser peel) can help with by decreasing the wrinkles and actually tightening the skin.  A small amount of volumizing also occurs with lasers with their creating of a thin collagen layer deep to the skin.

I hope that helps some!

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 Facial FillersFat Transfer or Facial 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

Can a forehead augmentation be done after a brow lift?

Wednesday, August 5th, 2009

Forehead augmentation can be done but can affect the results of previous browlifts. You can augment the forehead with silicone after a browlift.  One of the issues is that the augmentation will affect what was done with the previous browlift and you will sometimes need to refix the brows and allow them to fixate in the newer position.  Browlifts depend on the fixation of the bone to the bone covering and the soft tissue that covers the forehead.  When you dissect to implant something into the forehead it will break that bond.  Also with the implant fixating the brows to a new position will present some challenges as well depending on where the implant is placed.  Implants placed in the forehead can establish needed volume that is lossed with aging.  Most of the time, however, forehead augmentation is used to fill in defects from trauma and for reconstructive purposes. Also depending on what implant is used and the size you may need longer incisions such as a variation of the coronal incision that goes from ear to ear.  Not all of this incision is needed most of the time.  In terms of augmentation, you can use silicone sheets / blocks, Facial Fillers or fat augmentation.  Silicone and fat are the options that offer more of a longer lasting results with silicone being more permanent than fat.  Fat injections, however, can be done with no incisions most of the time with less downtime associated with long incisions. Augmenting the forehead can potentially help with wrinkles in the forehead, eyebrow drooping, extra eyelid skin and temple hollowing depending on how and where the augmentation is done.

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.  Dr Young employs 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.

Dr Young is located in Bellevue near Seattle, Washington

Treating bruising to the lips after restylane?

Sunday, July 5th, 2009

This is a question that I answered for a patient who hadLip Augmentation by another physician:

Prevention is the key to bruising and bleeding. You should always stop high dose vitamin E, anti-inflammatories, aspirin, herbal medication, supplements and any blood thinners 2 weeks before and after your injection or procedures.

These are elements that affect your body’s ability to clot your blood. Hence, if you are on these things during the time of your injection, you will have more of a chance for bleeding and bruising.

I also never suggest Arnica. I recently did a literature search and found that there is no scientific evidence to support Arnica’s ability to prevent bleeding and bruising. In fact, there were actually more evidence of adverse, or bad, effects from Arnica than good effects.

Genetics play a part and some people are just more prone to bruising.

In terms of the size or your lips, you can do something to correct that. The key here is to choose the right surgeon. You want someone that has a great understanding of facial aesthetics or what makes a face beautiful or not. I have discovered a theory on aesthetics that no one has been able to think of before. Our current theories, prior to my discoveries, have recently been found to be flawed.

If you are dissatisfied with the size and shape of your lips you can have an injection to reduce the size of it. Hyaluronidase is an enzyme that can take away Restylane. But you have to go to a surgeon that has experience with it to have a successful outcome.

In terms of bruising, you can alternate warm and cold compresses to the bruised area to help with increasing circulation to the area of bruising.  This should be done after at least the first 48 hours.  The increased circulation could help take away the residual blood products and colored deposits that are left where the bruise is.  Also prudent exercise could also help the bruising.  Again prevention is the key!

Dr Young is located in Bellevue near Seattle, Washington

Restylane or Arcus Marginalis release for lower eyelid dark circles

Sunday, July 5th, 2009

Both of those options can help. I think Restylane would be a better alternative to replace the volume that you have lost in the lower eyelid and cheek area. That is essentially what has happened — a loss of volume. The only thing is that restylane will last only 6-9 months. Fat repositioning can help the condition but there are limitations. It can leave you looking hollow and it can impact the position of your eyelids and can have complications.

I don’t prefer the fat repositioning procedure. I think volumizing the area is the best way to rejuvenate the face and the lower eyelid area. It can give you the most naturally looking results.  Fat transfer to this area is the best if done right.

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.  Dr Young employs 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

Restylane migrating to the bridge of the nose after injecting into the glabellar area

Sunday, July 5th, 2009

This is a question that I answered for a patient who had restlylane injections by another doctor in the glabellar area:

It may be possible that the injection was placed over the area that you are concerned about. In my experience, with local anesthesia and swelling sometimes the landmarks that you have when it wasn’t swollen can be altered and you can get confused where you are injecting.

That is why I make it a guideline for myself to make accurate markings prior to any local anesthesia that can distort the area when I actually do the injections. Don’t worry though you can inject an enzyme that can make the bump go away if you want and these injections are really not as involved as the original injection of restylane. Things can be done for this!

In terms of migration, I think that it is less likely that it migrated. From the literature, this is not very likely to happen.  I think that the above explanation might be the answer.  Don’t worry if it is the restylane that migrated, this can be taken out if you would like.

Dr Young is located in Bellevue near Seattle, Washington

Lower Lip Asymmetry and lumps after Juvederm

Monday, June 29th, 2009

In my experience, when there is extra oozing in the area, Juvederm is likely to pull in more volume than Restylane and can give you extra swelling in the area that has more oozing. This will go down over the course of a week. Don’t worry though you can always take some of the hyaluronic acid away with an enzyme injection consisting of hyaluronidase or wydase.

This can be done in a judicious way to make it look the way you want it to look.  the same goes for the lump. Massage is another way to help alleviate the differences.  You should ask your doctor to help you though this.  Massage is less likely to improve the lump and my experience the enzyme injections can really help in this situation.

I refined an amazing volumizing procedure called “the YoungVitalizer”.  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.  Dr Young employs 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