Looking in a mirror one day and saying to oneself, “My face looks so much older than I feel. How can I do something about it?” triggers a process of self analysis, investigation of (many) surgical and non-surgical options, and several difficult decisions. Not the least of these is deciding how best to spend your resources to best effect. It’s important to determine which of your facial features currently draw the most attention to your face and how those features could be improved.
Ask yourself:
Were your eyes once your most attractive feature but now they appear tired or drawn?
Were your cheeks once firm and rosy but now sag and appear hollow?
When once your smile lifted at the corners, does it now struggle against folds of skin at each side of your mouth?
Does your once smooth and defined jawline appear soft and droopy?
Pull out the family albums and examine photographs of your face over the past ten years (or more) to help you decide what you can gracefully accept in the aging process and what bothers you the most.
Set Goals and Find a Partner
Whether you decide it’s your facial lines and wrinkles, forehead and brow, eyes, nose, jaw or chin, set some priorities or goals before you schedule a consultation with a board certified plastic surgeon. That will enable you to target your questions and make the best use of the information your surgeon will give you. Take your photographs with you.
Be prepared to learn about an amazing array of surgical and non-surgical procedures and products to choose from. Make your surgeon your partner in deciding what would best achieve your objectives.
Sculptra is a great filler for patients that want the longest-term result possible but don’t have a problem waiting a bit for the full effects of treatment. All of my Northern California and San Francisco Sculptra patients made the choice to use Sculptra because they prioritize a natural appearance. And the nice thing about Sculptra is that when the filling is complete, it is the patient’s own natural tissue that is doing the filling.
Sculptra has gotten a bad rap because of reports of nodules beneath the skin that can form. Fortunately for me and my patients the technique I use is working to reduce the incidence of firm areas beneath the skin to less than 1% of patients. For me, as long as a patient has a few months to see the full effect of the volume, Sculptra is one of the best choices for facial filling.
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.
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.
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.
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.
Radiesse (formerly called Radiance) is a filler that provides instant results like Restylane and Juvéderm, but is made of a different material called hydroxyapatite. This is a calcium-based compound that is very similar to the natural material that makes up our bones (but of course it is in an injectable form). Because of its different ingredients, Radiesse lasts longer than hyaluranic acid dermal fillers, usually up to 12-18 months. It can’t be used for the lips, but Radiesse is excellent for the nasolabial and mental folds.
Therefore, Radiesse is an excellent balance between instant results and a longer duration of filling. For patients who would like a durable filling of the nasolabial folds of the face, Radiesse is one of the very best options available.
Hyaluronic acid (HA) is a natural complex sugar found the connective tissue matrix of the dermis (the dense, inner layer of skin just beneath the epidermis or outer layer of skin) in humans and all other mammals. Hyaluronic acid is the major component of this matrix which is also made of two connective fibers called collagen and elastin.
HA has the ability to absorb and hold water up to a thousand times it weight, hydrating the skin and giving it density and volume. HA also helps transport essential nutrients to the skin’s viable cells.
As you age and your skin is exposed to sun rays and pollutants your cells gradually lose the ability to produce HA and the result is dehydration. The collagen and elastin fibers also lose their structure and the combined result is loss of skin volume and the formation of the facial wrinkles and folds we associate with aging.
Such injectable fillers, usually in gel form, must be expertly injected into the mid or deep dermis to restore lost HA, thus restoring skin volume and firmness.The effect is not permanent, but can last up to a year or longer.
Many people suffer in silence from excessive sweating of the palms, armpits, forehead and chest areas. This is a distressing problem that can be socially paralyzing in public settings or where first impressions are key. However, this simple problem can be solved with Botox.As you probably know, Botox is used to relax facial lines and can last 3-4 months for this treatment.Botox for sweating will actually last twice that long, 6 months or longer before another treatment becomes necessary. Nicely, the reduction in sweating is dramatic – usually there is almost no sweating at all until the 6 month period has elapsed.
