Everyone has a chronological age based on their date of birth. But you also have a biological age based on a combination of up to 130 physiological biomarkers such as blood, urine, cognitive tests, muscle tone, lung capacity, etc., and that age may be ‘younger’ or ‘older’ than your chronological age.
A woman who has her biological age tested may be pleased to find that because she follows a healthy diet and active lifestyle she is ‘younger’ than her chronological age. But she may be less pleased if her face appears ‘older’ than her biological age, even though it may be in keeping with her chronological age.
Your face is more exposed to sunlight, weather conditions, soaps and cosmetics than any other part of your body so it may be aging faster than the rest of you. Sunlight induces clinical, histological and physiological changes in the skin known as photoaging.
If you feel that your face does not reflect your true biological age, there are many remedies available, both surgical and non-surgical. The effects of photoaging can be slowed down and even reversed. A consultation with a board-certified plastic surgeon or qualified dermatologist is a first step in achieving a ‘younger’ facial age.
Most of my patients who benefit from Botox® Cosmetic treatments to smooth out facial creases and frown lines aren’t aware that Botox was not originally intended for this purpose.
In the 1960s, while being studied as a possible germ warfare agent, several serotypes of the bacterium Clostridium Botulinum – the cause of botulism poisoning in food – where found to cause temporary paralyze of nerves and muscles when used in minute amounts without negative side effects.
The use of Toxin Type A, the most studied of the seven different serotypes, as a therapeutic agent began in the late 1960s, first as a pediatric treatment for crossed eyes and later as a common medical treatment for blepharospasm and strabismus, two kinds of facial spasms that occur around the eye. It was first approved as a medical treatment in 1989.
It wasn’t until the 1990s that Toxin Type A was considered for cosmetic purposes, and was approved by the FDA in 2002.
Now, in addition to being one of the most popular anti-aging treatments, Botox® is also used to treat hyperhydrosis (excessive sweating) and migraine headaches.
Juvéderm is one of the newest fillers on the market. It is made of a substance called Hyaluronic Acid, which is the same as the active ingredient in Restylane and they are very similar in their indications and results. In my experience Juvederm is a bit more fluid, which seems to result in less discomfort during the injections, and in many patients less bruising and swelling.
It is another material that can be used safely in the lips, and Juvéderm is easy to mold if necessary after injection. I really like Juvederm as well for filling of the nasolabial folds, lips and labiomental (marionette line) areas.
Fat grafting is the process of removing excess fat from one part of a patient’s body by liposuction, processing the fat removed, and then selectively injecting it into other areas of the same patient’s body.
Fat grafting has been in use for years for facial reshaping and to replace sunken areas caused by aging, surgery, or wasting illness. Esthetically satisfying results can be obtained, and since the patient’s own body fat is used the risk of allergic reaction is minimized.
A newer application for fat grafting is for facial rejuvenation.We are discovering that facial aging is more due to volume loss than skin sagging, and facial fat grafting or other volume replacement might be the only thing needed in some patients with early facial aging.
See your board certified plastic surgeon to discuss whether you are a candidate for fat grafting for facial rejuvenation.
Often, in spite of regular exercise and diet, you may find that you have excess fatty deposits under your chin or around your jawline. Even a very small excess of fat can spoil facial features that are otherwise smooth and youthful. There are two simple procedures which can be used to streamline your jawline – liposelection or surgical incision.
Usually one of two liposuction techniques are employed:tumescent (or super-wet technique) liposuction which requires an infusion of saline and a blood vessel constricting agent to prevent bleeding before excess fat is removed by suction; or Vaser liposelection, a patented technique also using ultrasound, which is safe and has the shortest recovery time. Depending on skin elasticity and the amount of fat removed the neck skin will retract to fit the new jawline contour.
Depending on the location, amount of fatty tissue, and the amount of excess skin that remains after the fat is removed, it may be necessary to make a surgical incision to remove the unwanted fatty tissue plus a small amount of excess skin. Tiny sutures made along the under side of the jawline to close the incision would leave a barely discernable hairline scar.
Streamlining your jawline may be done alone or, more frequently, in conjunction with a mini or full face lift.
The use of digital imaging in plastic surgery (that is, taking a photo and then changing it with a computer to show a patient what an example of a possible result looks like) is an area of great controversy. Proponents say that it is a useful adjunct to patient education, and opponents declare that it can seem like a false guarantee of results if not properly explained.
I have found digital imaging to be useful for a number of procedures in my practice, such as in rhinoplasty surgery, where imagining an appearance with certain changes can be difficult.Because we can control computer data more than real-world biological systems, I make it a point to remind patients that the images a computer produces are goals, and not an absolute representation of things to come. However this has been useful, when taken along with other means of communication, in continuing the dialogue that helps me learn as much as I can about a patient’s goals.
Migraine is an ailment experienced by 14%-35% of all females and 6%-15% of all males at some time in their lives.The incidence of this condition, evidenced by a moderate to very severe headache, varies widely with age and is more prevalent during middle age, being experienced by 25% of women and 10% of men.It was recently estimated that some 28 million Americans (or 12% of the population) suffer from migraines.
In the ongoing search for relief from the symptoms of severe and chronic migraine, controlled injections of botulinum A toxin (Botox®) into specific “trigger sites” on the face, head and neck, have resulted in temporary relief.The key to effective treatment is locating specific nerves and muscles and determining effective dosage.
I’ve had the pleasure of doing research in this exciting field, specifically on the anatomy of the greater occipital nerve to develop a surgical protocol for the injection of botulinum A toxin into the most effective trigger sites. For more details on Botox® injection therapy, see http://www.drmosser.com/botoxmigrainessanfrancisco.php .
Botulinum A toxin was used therapeutically for many years…and still is…to treat eye spasms, crossed eyes, and facial tics before it became one of the most popular dermal injections (in the form of Botox® Cosmetic) used in non-surgical cosmetic plastic surgery procedures to temporarily relax facial muscles that cause creases and wrinkles.
Many cosmetic plastic surgery procedures have been developed as the result of medical procedures, but the opposite occurred in the use of Botox® for migraine relief.Its use in migraine pain relief came about because migraine sufferers receiving injections for cosmetic reasons frequently reported relief from their migraine symptoms as a side effect.
I perform Botox® Cosmetic injections daily in my San Francisco plastic surgery practice and follow with avid interest the exciting research and development going on in the field.I recently spoke on the subject of my own research at the 2nd Annual Surgical Treatment of Migraine Headaches at Case Western Reserve University, Cleveland, Ohio (October 2007) and anticipate still more exciting developments in the near future.
For me, the most satisfying part of plastic surgery (and life in general) is when things come together smoothly and harmoniously. As a plastic surgeon, sometimes this moment of exhilaration will come in the operating room at the end of challenging procedure, with beautiful and balanced results.
Sometimes, the best moment of my efforts is immediately after a bandage is removed and patient sees his or her results. There can be great joy in realizing that the goals we have set out to achieve are accomplished, and I never get tired of sharing this moment with a patient.
But final satisfaction can even come months or years later at a long-term post-surgical visit. Often it’s great to see that a patient is visibly more secure and relaxed as a result of living more comfortably within their own better-balanced bodies after surgery.
Did you know that legally, any doctor can perform any type of surgical procedure? There’s nothing in the law that says a foot surgeon can’t change out a heart valve, or an eye doctor can’t perform a liver transplant. Therefore, our society depends on patients themselves to learn about their doctors’ credentials and to ask about training and certification before they sign up for surgery.
Another thing you may not know is that many different groups of doctors have formed “boards” of this-and-that which have no national recognition whatsoever.
The highest authority in the country for medical education is called the American College of Graduate Medical Education (ACGME). This institution declares what boards are worthy of approval, and in a sense they are the most important line of protection for the public in medicine.Of all the groups that practice, perform and sometimes dabble in cosmetic surgery, only the American Board of Plastic Surgeons (ABPS) has ACGME approval to provide board certification in Plastic Surgery.There can be treacherous waters out there – remember to ask the questions necessary to make sure your doctor is qualified. Is he or she ABPS certified?
A walk through the cosmetic section of any department store, or even a stroll through the aisles of your local drug store, will leave you both amazed and confused by the tremendous number of creams, gels, and serums specifically formulated for treating the wrinkles and creases that are a part of the face’s natural aging process. Many contain ingredients once found only in your plastic surgeon or dermatologist’s clinic.
Cosmetic companies spend millions of dollars on promoting these products, and their message inevitably is that going to a plastic surgeon is expensive, but that the “face lift in a jar” they offer will give you the “same results for a lot less money”.
There’s nothing wrong with these lotions and potions when they’re manufactured by reputable cosmetic or drug companies. Many clearly contain ingredients that have been found to be very effective in repairing wrinkles and filling in facial creases. But the dizzying list of ingredients on the package can be misleading.
The problem lies in the concentrations and the effectiveness of the delivery of the active ingredients into the skin layer where it might even begin to be beneficial. If the product cannot deliver a sufficient amount of the active ingredient to the right place its effects will ultimately be disappointing, not to mention expensive.
Many women (and men, too) have experienced significant improvement after applying some of these highly promoted products, but often the improvement is simply due to their daily application of moisturizing creams to facial skin that had been sorely neglected for years. The anti-aging effect at the inner layers of skin simply isn’t taking place because the active ingredient doesn’t succeed in penetrating the epidermis, or outermost layer of skin.
Board-Certified plastic surgeons and licensed dermatologists use fine needles to inject dermalfillers under the epidermis into the layer of the skin called the dermis where the aging is actually taking place due to a reduction in collagen or moisture retention capability. Dermal fillers are specifically formulated to fill in creases, add collagen, or stimulate the skin’s natural water retention or collagen production capabilities so your face actually becomes smoother, plumper and more youthful looking.
The effects of dermal filler treatments can last for months or even years which makes them cost effective. It can turn out to be less expensive in the long run to go to a plastic surgeon or certified dermatologist for treatments that are tailored to your individual skin needs and deliver significant and satisfying results.
