Archive for the ‘Sculptra’ Category

Since you inject radiesse deeper do you have less bruising than compared to restylane?

Wednesday, December 15th, 2010

by Dr. Philip Young | Aesthetic Facial Plastic Surgery:

Bruising with radiesse and restylane really depends on the technique. Yes if things are placed deeper, there is less visibility for the most part. Since radiesse is in general placed deeper it seems to have less bruising.  But it really depends on a lot of factors like genetics of the patient, whether they have been on blood thinners, whether local anesthesia was used which can increase the bruising.

Facial Fillers

Restylane For Under The Eyes

 

Thanks!, 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 by Dr. Philip Young of Bellevue | Seattle:

Tuesday, February 23rd, 2010

Fillers and Fat injections for Cheek Augmentation by Dr. Philip Young of Bellevue | Seattle:

Fillers Upper Lower Eyelid Eyelift

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

Rejuvenating the Mouth Area through Fat grafting by Dr. Philip Young of Bellevue | Seattle

Saturday, February 13th, 2010

Rejuvenating the Mouth Area through Fat grafting by Dr. Philip Young of Bellevue | Seattle:

YoungVitalizer Before After Pictures

YoungVitalizer Before After Pictures

The mouth area undergoes a lot of changes that can contribute to nasolabial folds, marionette lines, smoker lip lines and a downturned mouth.  Volume loss plays a major role in these changes.  Replacing this volume can have a profound impact in rejuvenating the aging mouth and the YoungVitalizer is our approach to improving this area.  Fat injections are a great way to do this and other fillers can help as well.  Sculptra can help if fat is not available.  Fat and Sculptra are good options for permanent or semi-permanent effects.  By this, I mean results that last more than 1 year. The picture below shows the locations of the nasolabial folds, marionette lines, and prejowl volume loss.  All of these issues can find their origination from volume loss to a large degree.  For the nasolabial folds, there are studies that show specific fat pockets that when re volumized can play a major role in eliminating nasolabial folds.  Specifically the area lateral to the nose and immediately deep to the most medial and superior area of the nasolabial folds is the area where re volumizing can play a big role in reversing nasolabial folds.  Furthermore volumizing in the whole area inside the nasolabial folds and marionette lines can rejuvenate the peri oral and mouth area.  Volumizing in the area immediately medial to the marionette lines can diminish these lines.  Volume in the prejowl area will blend this area in a more pleasing way with the jowls and in turn make them seem less apparent.  This is in line with the whole idea of doing prejowl implants with facelifts to improve the jawline.  Also volumizing the chin can restore this whole area as well and give support for the other areas that are volumizing.  One important thing that I have learned is that volumizing other adjacent areas can help support other areas by aiding in the volume expansion.   An example is if you place on stake in the ground and place a very heavy tarp over this stake.  It is more likely that you will form a nice area under that tarp the more stakes you put under the tarp.  It is also more helpful the more stakes you spread out in the area to give the original stake support.  Volumizing the chin is analogous to this idea.  When you volumize the chin it supports the volume you put in the prejowl area as well.  More likely than not your chin has lost volume as well and volumizing deep to the chin will rejuvenate your lower third or lower mouth area.  Also people are likely to develop deep wrinkles in the labio mental sulcus which is the crease that is under the lower lip.  Volumizing deep in the chin just inferior to this crease will help to eliminate this crease.

Thanks for reading, Dr Young

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

Perioral Diagram

Sculptra injections and how they are administered

Friday, January 15th, 2010

Sculptra injections are conducted like other fillers.  Usually topical medications are used to numb the skin.  Then sculptra is usually reconstituted with lidocaine local anesthetic.  Together this allows the injecions to be done in a tolerable way.  Sometimes nerve blocks are done to make the injections easier.  There are multiple nerve blocks that you can do to make the Sculptra injections more tolerable.  But these “dental blocks” are not for everyone.  Sometimes, people prefer topical anesthetics and the anesthetics in the Sculptra itself without nerve blocks.  But if additional numbing is required nerve blocks can make the procedure more tolerable. A few injections are usually needed for each area.  The first injections are always the more difficult ones.  Once the first injections begin to allow the local anesthetics to take effect, subsequent injections are much easier to tolerate.  They are usually given every 6-8 weeks.  The sessions take about 1/2 hour.  You are a litle swollen but this goes down shortly in a matter of hours.  The Sculptra then begins to incite an inflammatory response that eventually creates the volume that is needed in the form of collagen.  This process of building collagen can take months to about a year.  This process of collage formation creates the volume that helps make people look younger.  The key to getting a good result is really technique dependent. You have to know where to put the volume to rejuvenate the face.  If you don’t, you can accentuate more of the curves that lead to aging rather than the reverse. Unlike other fillers, Sculptra takes time to work with less instant gratification but more long term results. Here is a live demonstration on Sculptra injections.

Thanks for reading, Dr Young

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

What is a good option for something in place of Sculptra? What are the alternatives?

Wednesday, January 6th, 2010

Fat injections are the best option as an alternative to Sculptra injections. I even consider fat injections first before Facial Fillers. Nothing is better than using your own tissues for plastic surgery purposes.  You have essentially no risk for reactions, no risk for cancer, no toxicity from your own tissues. Sculptra is made up of suture material. It is a foreign substance that is essentially broken down into carbon dioxide and glucose and ultimately carbon dioxide and water.  Other ways of filling is through silicone implants. The problem areas for implants and Sculptra is the periorbital area.  Implants are also hard to use for the buccal area where there is no bone for the implant to rest on.  It is here that Sculptra can be used and Fat injections.

Thanks for reading, Dr Young

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

Is Sculptra in the lips a good idea?

Wednesday, January 6th, 2010

Facial Fillers has the potential for nodules and this can be more of an issue in the soft tissue of the lips. The makers of Sculptra, due to prior treatments to the lips, have concluded that Sculptra in the lips is not advised.  Other options for lip augmentation include restylane, juvederm which are temporary fillers for the lips. Some permanent options include fat injections, lip lifts, vy advancements, corner of the lip lifts, tissue grafts for the lips, etc.

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

What are the long term side effects of Sculptra? Is it a smart choice? Who are the best candidates?

Wednesday, December 30th, 2009

Facial Fillers is actually the powder form of a suture, Vicryl, that has been used in surgery for many years without significant problems. The body absorbs the powder and eventually turns it into carbon dioxide and water. The benefit of Sculptra is that during this inflammation to degrade the Sculptra collagen formation is being carried out by the body in a scar like reaction. It is this collagen that creates the new volume.  With this inflammation there is the risk of infection.  However the benefit of having the inflammation to create the collagen in a scar form is paradoxically what can lead to the infection.  If you didn’t have this inflammation you wouldn’t have as much collagen formation.

In my opinion, Sculptra is most beneficial for the person who does not have a lot of fat in the rest of the body to undergo fat injections and would like some more volume in the face.  It is also useful in the person who has only a little fat to offer for fat injections.  In this particular situation I would use sculptra in the areas that can tolerate it more such as the cheeks, mouth area, temples, forehead and jawline areas and reserve fat injections for the areas closer to the lips and around the eyes.  It is also good to use Sculptra for people who don’t want the invasiveness of fat injections where you have the need to harvest the fat from somewhere else. Sculptra, in general, is less of a process than fat injections.  But with the negatives that come with Sculptra, there is a lot of positives for people in these situations above.

From a long term standpoint, once the Sculptra is dissolved there should not be long terms issues. If a person somehow does not degrade the Sculptra effectively there could be infections but there are ways to treat these issues without a lot of problems.  Silicone injections and Artecoll injections present more long term issues in my opinion.

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