Thursday, July 30, 2020

Restoring Facial Volume: Fat Grafting vs. Fillers


For many years, facial rejuvenation was limited to skin resurfacing with lasers and peels, 
and various surgical soft tissue repositioning procedures. However, our options have 
expanded with the understanding of muscle relaxation via neurotoxins such as Botox,
 and the evolution of our knowledge of how fat atrophy in the face leads to stereotypical 
architectural changes with aging. Plastic surgeons can now add volume to refresh the face. 

In order to achieve a youthful but natural appearance for my patients, I use a combination 
of muscle balancing, skin resurfacing and tightening, as well as volume restoration.

 Ultimately, when the battle of gravity versus skin plays out over time, 
surgical repositioning is required.



Restoring Facial Volume: Fat Grafting vs. Fillers

Tuesday, July 14, 2020

BOTOX® Cosmetic (onabotulinumtoxinA) Important Information

BOTOX® Cosmetic (onabotulinumtoxinA) Important Information


Indication

BOTOX® Cosmetic is a prescription medicine that is injected into muscles and used to improve the look of moderate to severe frown lines between the eyebrows (glabellar lines) in people 18 to 65 years of age for a short period of time (temporary).

IMPORTANT SAFETY INFORMATION

BOTOX® Cosmetic may cause serious side effects that can be life threatening. Call your doctor or get medical help right away if you have any of these problems any time (hours to weeks) after injection of BOTOX® Cosmetic:
Problems swallowing, speaking, or breathing, due to weakening of associated muscles, can be severe and result in loss of life. You are at the highest risk if these problems are pre-existing before injection. Swallowing problems may last for several months

Spread of toxin effects. The effect of botulinum toxin may affect areas away from the injection site and cause serious symptoms including: loss of strength and all-over muscle weakness, double vision, blurred vision and drooping eyelids, hoarseness or change or loss of voice (dysphonia), trouble saying words clearly (dysarthria), loss of bladder control, trouble breathing, trouble swallowing. If this happens, do not drive a car, operate machinery, or do other dangerous activities

The dose of BOTOX® Cosmetic is not the same as, or comparable to, another botulinum toxin product.

There has not been a confirmed serious case of spread of toxin effect when BOTOX® Cosmetic has been used at the recommended dose to treat frown lines.

Serious and/or immediate allergic reactions have been reported. These reactions include: itching, rash, red itchy welts, wheezing, asthma symptoms, or dizziness or feeling faint. Tell your doctor or get medical help right away if you are wheezing or have asthma symptoms, or if you become dizzy or faint.

Do not take BOTOX® Cosmetic if you: are allergic to any of the ingredients in BOTOX® Cosmetic (see Medication Guide for ingredients); had an allergic reaction to any other botulinum toxin product such as Myobloc® (rimabotulinumtoxinB), Dysport® (abobotulinumtoxinA), or Xeomin® (incobotulinumtoxinA); have a skin infection at the planned injection site.
Tell your doctor about all your muscle or nerve conditions, such as amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease), myasthenia gravis, or Lambert-Eaton syndrome, as you may be at increased risk of serious side effects including severe dysphagia (difficulty swallowing) and respiratory compromise (difficulty breathing) from typical doses of BOTOX® Cosmetic.

Tell your doctor about all your medical conditions, including if you have: plans to have surgery; had surgery on your face; weakness of forehead muscles, such as trouble raising your eyebrows; drooping eyelids; any other abnormal facial change; are pregnant or plan to become pregnant (it is not known if BOTOX® Cosmetic can harm your unborn baby); are breast-feeding or plan to breast-feed (it is not known if BOTOX® Cosmetic passes into breast milk).
This product contains albumin taken from human blood. Steps taken during donor screening and product manufacturing processes make the risk of spreading viral diseases extremely rare. In theory, there is also an extremely rare risk of contracting Creutzfeldt-Jakob disease (CJD). No cases of spread of viral diseases or CJD have ever been reported for albumin.

Tell your doctor about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal products. Using BOTOX® Cosmetic with certain other medicines may cause serious side effects. Do not start any new medicines until you have told your doctor that you have received BOTOX® Cosmetic in the past.

Especially tell your doctor if you: have received any other botulinum toxin product in the last 4 months; have received injections of botulinum toxin, such as Myobloc®, Dysport®, or Xeomin® in the past (be sure your doctor knows exactly which product you received); have recently received an antibiotic by injection; take muscle relaxants; take an allergy or cold medicine; or take a sleep medicine.
Other side effects of BOTOX® Cosmetic include: dry mouth, discomfort or pain at the injection site, tiredness, headache, neck pain, and eye problems: double vision, blurred vision, decreased eyesight, drooping eyelids, swelling of your eyelids, and dry eyes.
For more information refer to the Medication Guide or talk with your doctor.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please see BOTOX® Cosmetic full Product Information including Boxed Warning and Medication Guide.

Botox battle: Allergan attempts to block sale of injectables competitor in US market with support of ITC

Botox battle: Allergan attempts to block sale of injectables competitor in US market with support of ITC: The US’ International Trade Commission agreed that Daewoong’s rival product, Jeuveau, was unfairly sold in the US market, however, the full details of the decision have not yet been disclosed

Monday, July 13, 2020

AbbVie draws first blood in trade secrets war between Allergan's Botox and Evolus

AbbVie draws first blood in trade secrets war between Allergan's Botox and Evolus: AbbVie's Allergan and Evolus have been locked in a yearslong trade secrets fight involving the two drugmakers' South Korean partners and blockbuster Botox. Despite some early signs in Evolus' favor, a U.S. trade judge has now flipped the script on the California drugmaker's underdog Botox challenger.

Monday, June 15, 2020

Danger zones for dermafillers !!!

The high risk areas for arterial/venous occlusion when injecting dermafillers are the temple, glabella, nose, cheek, nasolabial folds, lips, and lower face. It is virtually the entire face. Injury of vessels may result in embolisation (resulting in visual loss), blockages (tissue necrosis), severe bruising, and volume compression. There can also be injury to nerves.

Tuesday, April 28, 2020

UV light with ties to Englewood company could be new tool in fight against COVID-19

UV light with ties to Englewood company could be new tool in fight against COVID-19: ENGLEWOOD, Colo. (KDVR) — President Donald Trump’s comments about possibly injecting patients with disinfectants to treat COVID-19 may have overshadowed his remarks at the same time about the…

Monday, April 20, 2020

What Are Facial Fillers?

What Are Facial Fillers?

Facial fillers are products such as collagen, hyaluronic acid and calcium hydroxyl apatite that rejuvenate facial skin by reducing or eliminating wrinkles, raising scar depressions, enhancing lips and replacing soft-tissue volume loss through facial injections. With age, our skin becomes more susceptible to wrinkles and sagging. Exposure to sun and years of muscle movement ( squinting, chewing, smiling ) contribute to tissue breakdown of the skin.



Facial fillers are temporary to long-lasting solutions administered through a few tiny facial injectionson specific areas of the face. Various types of facial fillers are available; each is designed with one or several purposes, such as wrinkle reduction and lip augmentation. A qualified dental or medical professional can help you determine which facial injections and what injectable fillers treatments are right for you. Facial fillers will volumize creases and folds in the face in areas that have lost fat and collagen as we age. Hyaluronic acid is the natural filler substance in your body. The face starts to lack volume and appears aged with deeper nasolabial folds, unaesthetic marionette lines, a deeper mentalis fold, the lips start to thin, and turning down the corners of the lips. Hyaluronic acid fillers such asRestylane and Juvederm are then injected extraorally right underneath these folds to replace the volume lost which creates a younger look in the face. Dermal fillers can be used for high lip line cases, asymmetrical lips around the mouth, lip augmentation, and completing cosmetic dentistry cases by creating a beautiful, young-looking frame around the teeth

Friday, February 28, 2020

Lip Augmentation

Lip augmentation creates fuller, plumper lips and reduces fine wrinkles around the mouth. Lips may be injected with collagen or with fat transferred from another site in the patient's body. Both liquid collagen and fat are absorbed and repeat treatments are necessary to maintain results. Newer, longer-lasting options include implantable materials like AlloDerm and SoftForm.


Technique:


A natural or synthetic biocompatible material, or the patient's own fat, is injected or implanted in the lips. One injection is usually sufficient to produce the desired result, which may be temporary, depending on the material used. Injections may need to be repeated periodically. Proper placement of the injected material is important. AlloDerm, a natural collagen sheet made from donated skin, is inserted through tiny incisions inside the corners of the mouth. Once the AlloDerm implant is in place, it eventually becomes integrated with the natural tissues. Gore-Tex, SoftForm and soft ePTFE are other synthetic implant options.

Further options include:


  • Autologen - injectable dermal implant material made from the patient's own skin.
  • Dermalogen - injectable Human Tissue Matrix (HTM) procured from donor tissue.
  • Fascia - injectable donor tissue made from the dense white connective tissue that supports body structure. Can also be done as a surgical implant.
  • HylaForm - a crystal-clear injectable gel; the hyaluronic acid in Hylaform is similar to that naturally found in the body.
  • Radiance - calcium hydroxylapatite
  • Restylane - crystal-clear injectable gel; the hyaluronic acid in Restylane is very close to that naturally found in the body.
Another augmentation choice is laser lip rejuvenation, which tightens the natural collagen and elastic tissue beneath the lips.

Friday, February 21, 2020

The science of rejuvenation....

The science of rejuvenation

What is aesthetic medicine?

No longer willing to accept the visible signs of aging, an increasing number of women and men are seeking treatments to help them look as vibrant as they feel.
Thanks to aesthetic medicine, millions of people around the world can now look and feel younger for longer. A fast-growing field, aesthetic medicine is the art of rejuvenating skin and enhancing facial beauty through safe, physician-administered treatments based on breakthrough science.

About fillers and botulinum toxin Type A.

Most popular aesthetic treatments are fillers and Botulinum toxins, which are well-tolerated, injectable treatments that help, smooth the appearance of wrinkles or compensate volume deficits creating a beautiful appearance.
Botulinum toxins are purified substances that relax the facial muscles stop them from contracting and smooth the skin. The degree of muscle contraction impairment can be varied to soften the lines while maintaining the ability to elevate your eyebrows.

Botulinum toxin Type A is very well tolerated and safe for longer-term use.

Fillers plump up wrinkles by replacing lost volume in the skin creating a more youthful appearance. There are many types of wrinkle fillers; some of them are based on hyaluronic acid or collagens which are known for their safety and lifting capacity.

Source:  Merz Aesthetics

Tuesday, February 4, 2020

Wrinkle Injections - Methods

As far as the treatment process is concerned, wrinkle correction via injection is similar to wrinkle correction procedures with botulinum toxin, e.g. botox®. Only the active mechanism is different, which is why different substances are also injected. Whereas treatment using botulinum toxin, e.g. botox®, involves inhibiting the contraction of the muscles in order to smooth wrinkles, wrinkle injection using tissue filler achieves the smoothing of wrinkles by filling slackened parts of the skin, providing support for the tissue, or increasing the amount of moisture and elasticity in the skin through the injected material.

Possible tissue fillers used for this procedure are natural substances known as bio-implants, synthetic preparations, or one's own body fat. The described substances are injected under the wrinkles using fine needles under local anaesthesia; autologous fat (fat from one's own body) is removed from a separate spot on the body in advance via suction. Among the most commonly used bio-implants are collagen and hyaluronan; synthetic polylactic acid is also often inserted.

Collagen is a natural protein taken from animal skin that is cleansed and prepared for injection using a special process. Once it is injected under the wrinkles, it binds itself to the body's own collagen, fills up slackened skin parts, and forms a natural protective framework for the surrounding tissue. Swelling after the procedure generally goes down within 24 hours. Hyaluranon is what is called a natural polysaccharyl, which is responsible for the lubrication and elasticity of the skin. With increasing age, hyaluranon content in the skin decreases; this can be compensated through the injection of colorless gel in some cases, thus raising sunken skin tissue.

Crystalline polylactic acid likewise effects an increase in the volume of collagen fibres and stimulates the formation of new fibres, which ultimately leads to a soft buildup of tissue and resulting mitigation of wrinkles.
In order to obtain the most complete results, it may be necessary, depending on the characteristics of the wrinkles, to repeat the treatment involving the above-mentioned filling substances at intervals of 1-2 weeks. For injections of polylactic acid, there should be at least four weeks between treatments.

"Frown lines" (glabellar wrinkles) on the forehead as well as folds between the nose and mouth (nasolabial folds) can also typically be treated via the injection of autologous fat. The fat previously removed from another spot on the body under local anaesthesia is injected, thus achieving increased volume and tautening of the skin.

Friday, January 17, 2020

Wrinkle injections for around the mouth


Wrinkle injections are becoming increasingly available for people who want to wipe a few years from their face.  Injections come in different varieties and use different methods to remove wrinkles.  These methods range from using toxins to paralyze face nerves to using gels and filler acids to “fill in” the wrinkles.  While none of these injections are miracle fixes, and some of them have side effects, many happy customers return to their doctors for repeat injections.

Collagen wrinkle injections provide a temporary solution  for scar and wrinkle reduction or lip enhancement.  A natural protein derived  from cattle, collagen injections can cause allergic reactions in some people.   For this reason, an allergy test is usually performed a month before treatment.   Results typically last between six months and a year.  However, some people  absorb collagen into their skin rapidly, making the results less effective.
One of the newest wrinkle injections on the market is Juvederm.  Juvederm, an injectable gel, has nearly identical results to Restylane.  It removes crow's feet, laugh lines, frown lines and under eye hollows.  It is also frequently used as a lip plumper and can be used to fill in scars on the face.  Juvederm is popular with users and physicians.  It is a more pleasant experience for the user and physicians find it easiest to use.  Juvederm injections can be done every 6 - 9 months.
A very fine needle is used to administer wrinkle injections to select muscles of the face.   As these muscles become immobilized, the facial skin begins to smooth and fine  lines and wrinkles start to soften.  A treatment typically takes 30 minutes.  It  may take four to seven days, however, for the full results of the wrinkle injections to  become apparent.

Muscle relaxing injections serve best to smoothen out the face wrinkles.  They work by blocking the function of muscle that cause wrinkles.  Different types of injections are available and it is our choice to choose the best among them.


Wrinkles around mouth  is an issue of which lots of folks experience particularly ladies.   Majority of these facial lines could appear anywhere on your face although it seems that the most noticeable part is whenever it forms lines from the bottom of your nose all the way down to the edges of your mouth.

The presence of wrinkles around mouth affects your self-esteem.  They customarily appear on the area from the base of your nose down to your mouth.  The worse thing is that its location makes them so obvious.  That is why when you see them in the mirror you want them to be removed straight away.

It has long been suspected that wrinkles around mouth has been more of a problem for women than for men.  Those wrinkles are called perioral wrinkles, and a recent study indicates that biology may be the culprit in terms of women being more prone to them than men.
There are many factors that cause wrinkles around mouth.   The most typical is the excessive facial movements and expressions like when you're frowning, thinking too hard, smiling or annoyed.   Environmental components such as too much sun exposure and pollution can result into early aging that will be the reason behind your wrinkles.

People want to get rid of wrinkles around mouth as it can make a positive change to their entire appearance.  And one can adopt a lot of ways to get rid of wrinkles around mouth.  Since unhealthy skin can also be one the culprits, you can get rid of wrinkles around mouth, by making some substantial changes to your diet.  Usually a diet which constitutes of vitamin E filled fruits and vegetables can help you to combat wrinkles, and in certain cases, the development of wrinkles can get delayed as well.

One of the first sign of aging is the wrinkles around the mouth which are called the smile lines.  As the production of collagen slows down with aging, the skin's elasticity breaks down, resulting in those wrinkles.  It is further hastened by smoking and sun exposure without proper care.  But the good news is, there are many professional skin care products that will help you to reduce wrinkles around mouth.  There are some natural home remedies as well.
The most expensive skin care is not necessarily the best one either.  On the contrary, an inexpensive product may show tremendous results on your skin simply because it may contain more effective natural ingredients.  It is highly recommended that when choosing an anti-wrinkle product, select one with ingredients that are safe and natural, especially when using on wrinkles around mouth.

Tuesday, January 14, 2020

Can Botox wash away your blues?

Can Botox wash away your blues?



You've probably heard Botox can treat frown lines - those pesky facial wrinkles that appear around the corners of the mouth. But could the injectable medicine also help ward off depression? That's what researchers at the Chevy Chase Cosmetic Center in Maryland suggested at the recent annual meeting of the American College of Neuropsychopharmacology, reports Time magazine.  
The medical director of the center and his colleagues presented a study that suggested treating frown lines and reducing the signs of aging could help those suffering from depression feel happier. The background of the research has its roots in history - Charles Darwin coined the term "grief muscles" to describe the muscles we use to frown, and he suggested making an unhappy face was intensely connected to true feelings of sadness.
"We feel sorry because we cry. We feel angry because we strike [out], and not vice versa," explained the lead researcher during the meeting. According to Time, he hypothesized that freezing the "grief muscles" with Botox could prevent individuals from frowning, thus breaking or weakening the connection the facial expression has with the emotion of sadness.
Researchers looked at 84 individuals who had severe depression lasting for an average of two years, none of whom had responded to antidepressants. Some of the participants were given Botox injections while others were injected with a placebo. They were then assessed three to six weeks later. According to the news source, at that time just over a quarter of those receiving Botox had a "nearly complete remission of their depression," while only 7 percent of those who had received the placebo reported the same turnaround.
Until this study undergoes further vetting, Botox shouldn't be considered an official treatment of depression. However, the medicine does carry other benefits, according to the American Society of Aesthetic Plastic Surgery (ASAPS). The injectable cosmetic can reduce the appearance of wrinkling around the mouth, forehead and eyes, giving patients an overall younger appearance.
What's more, Botox is more affordable than other rejuvenation procedures like facelifts, though the results don't last as long. Side-effects are also minimal - patients can expect mild swelling or bruising and a temporary redness. Botox is a good "first-time procedure," because patients' appearance will return to normal if they decide it's not the right look for them. 

The mission of the American Society for Aesthetic Plastic Surgery (ASAPS) includes medical education, public education and patient advocacy. Plastic Surgery News Briefs are summaries of current stories found through various news and magazine outlets that relate to or mention plastic surgery and cosmetic procedures. The views expressed in these news articles do not necessarily reflect the opinions of ASAPS, but are merely published as an educational service to our members and the general public. For additional information on these subjects and other plastic surgery related topics, please go to www.surgery.org

Friday, January 10, 2020

Types of wrinkles

There are two types of wrinkles: dynamic wrinkles and very fine lines and wrinkles.
Dynamic wrinkles are caused by facial muscles that move when you smile, laugh, and squint. These are often around the lips, on the forehead and between the eyebrows. They are also the “crows’ feet” at the corner of your eyelids. Everyone is born with dynamic wrinkles. As you age, these wrinkles get deeper and easier to see. Botulinum toxin can be used to make these dynamic wrinkles less noticeable.

Very fine lines and wrinkles are formed when collagen in the skin starts to thin. Collagen is protein just beneath and within deep skin layers. Aging and sun damage cause collagen thinning. It makes the skin on your face stretch and sag, creating fine wrinkles. Botulinum toxin does not erase fine lines and wrinkles. However, there are other ways to reduce their appearance.