There are numerous options available to the plastic surgeon to rejuvenate the upper face, or what we call the brow. Both non-surgical options and surgical options are available. Non-surgical options offer the patient a quick improvement with little to no recovery. Surgical options vary in their degree and scope and do require some recovery. Surgical options for brow rejuvenation include eyebrow elevation through an eyelid incision, corregator muscle ablation through an eyelid incision, endoscopic browlift, and open browlift. The first two of these surgical options are limited procedures both in their scope and recovery. This may be ideal for the patient who only needs elevation of the brow but is not bothered by brow wrinkles or the patient that needs to have the muscles that cause the 11 lines weakened. However, many patients opt to have a full rejuvenation of the upper face and this is where either an endoscopic browlift or an open browlift comes into play. Endoscopic browlifts are performed via small incisions in the hair-bearing scalp. Through these small incisions, a camera on a tube called an endoscope is inserted to visualize the anatomy. The brow is then elevated off the frontal bone and the muscles of brow animation, the nerves and blood vessels, are identified. The muscles as necessary may be divided to decrease motion and then the brow elevated. Numerous techniques such as screws, plates, and tongs have been used to maintain the brow elevation but internal sutures are efficient for most skilled surgeons. Open browlifts are performed in a similar manner however they utilize an incision that follows the brow hairline. The major advantage of the open technique is that the surgeon can use it to not only elevate the brow but also to lower the hairline. Many patients find that as they have aged their hairlines have receded. This procedure when performed with a beveled incision, can allow for brow rejuvenation while decreasing the height of the hairline and hiding the incision so that the scalp hairs actually grow through the scar. This camouflages the scar so patients may wear their hair up.
Archives for March 2014
Face it, for most people, getting rid of unwanted hair is a daily drudgery. Alternatives that allow for less shaving are painful, costly, and need to be repeated forever. Waxing, electrolysis, and even laser treatments are painful and in some cases require topical medication to soothe the pain. Pain-Free, Hair-Free™ laser hair removal with the Soprano Laser by Alma is a painless, permanent hair reduction treatment system. It truly is painless for most patient’s…even men. Laser hair removal works because the laser energy is absorbed by melanin (a pigment) within the hair follicle. Most laser hair removal systems are very painful as the laser energy is applied to the skin. In addition, they only work for very dark, coarse hair and cannot be used on dark skinned patients. The patented Soprano laser system is safe for all skin types, for hair colors, and on any hair types. The system gently and safely heats the targeted areas of hair with pulses of energy that are directed to the hair follicles. The systems cooling mechanism makes the skin comfortable and the process enjoyable. Many patients report that the technique reminds them of a hot rocks massage. Hair usually grows in several stages: Anagen, Catagen, and Telogen. The Catagen and Telogen stages are when the hairs have stopped growing and are resting. The Anagen phase is when the hairs are actively growing. This is the phase when the laser treatment is effective. Typically, 25% of the hairs treated in a given area are going through their Anagen phase. This means that to hit all the hairs effectively, the patient will need 4-6 treatments. As many patients grow new hairs throughout their life, some may require touch-up treatments two years after they were first treated. All regions of the body can be safely treated. Men who are tired of shaving their heads or beards can have these areas effectively treated. Backs and chests can be treated in 15-20 minutes. Legs, bikini areas, underarms, and private regions can be comfortably treated with the system.
The Brazilian Butt Lift, otherwise known as fat transfer to the gluteal region, is designed to enhance the shape and size of the buttocks. The technique utilizes minimal incisions and allows for a fairly fast recovery and return to normal activity. Fat transfer is a technique that is several decades old but has only within the last years, become fairly standardized and routine. In the past, fat transfer was fraught with fat loss and volume loss after the fat was transferred.In the 1990’s, it was discovered that if the fat was injected in very small amounts throughout a given region, then most of the fat would survive. This is because the small fat cells were surrounded by healthy tissue that would allow for blood vessel in-growth into the transferred fat. The reason fat did not take with other techniques is because the fat was injected as a large glob and new blood vessels could not grow in before the fat began to die. Dr. Schneider uses liposuction to harvest fat from one region of the body and then concentrates the fat and injects it into another. The procedure starts by making a tiny hidden incision in the area for liposuction. Then a fluid called tumescent solution is injected into the fat of the area. The tumescent solution helps prevent bleeding and also provides anesthesia to the area. Classically patients are sedated or asleep for the procedure, however, many have opted to have the operation done while they were awake. The patient is then repositioned for the fat transfer. Several small punctures are made in the gluteal region. The concentrated fat is then injected into the gluteal region in small aliquots until the desired shape and size is created. Band-aids are then applied. Patients are instructed not to sit or lay on the area for several days but they may shower and begin activities the next day. The result: an enhanced more shapely buttocks and a contoured smaller region that underwent liposuction.
You look in the mirror and the reflection you gaze upon is starting to resemble your mother or father. Yikes! Did this happen overnight? It may have seemed to. For many it may be a gradual process that at a certain point becomes undesirable. What happened? Can you get that youthful healthy look back? Can you look as good as you feel? Below the skin sitting on top of and around the muscles, is a collection of fat pads. The volume of the different fat pads changes with the aging process. Some compartments tend to decrease in size while others increase and some remain the same. Fat regions that decrease in size tend to produce characteristic hollowing of the aged face. These are located in the temples, in the cheeks and in the chin. As they sit next to areas that may stay the same or increase, this accentuates what patients see as the jowl, parentheses lines (nasolabial folds), and marionette folds. In addition to changes in fat pad volume, the face also undergoes loss of bone thickness. This is seen in the orbit, the bones that hold the eyes in position, and in the maxilla and mandible, the bones in the central portion of the face and jaw. The sagging in the face that accompanies aging is due partially to this loss of volume. The skin and soft tissue structures do not shrink so this larger envelope now sags on a smaller frame. True rejuvenation aims to reset the clock of aging by restoring volume. This can be done surgically with fat transfer or, it can be done non-surgically with Sculptra Injections. Sculptra™ is made from the same material as absorbable sutures. It comes as a powder that the Dr. Schneider mixes with water and xylocaine (a local anesthetic). When Sculptra™ is injected into the soft tissues it stimulates the body to produce new collagen. This new collagen adds volume to the region where the product was injected. Gradually, over six weeks, Sculptra™ works its magic and the body gradually produces collagen to fill in the regions treated. In numerous studies, Sculptra™ has been demonstrated to last a minimum of two years. Most patients will occasionally come in for a touch up of volumization as they see the continued effects of the aging process.