Dermal Fillers

Your Age Defying Questions Answered: Secrets to Defying the Aging Process

facial-rejuvenation-emailAging is a part of life. And yes, your appearance will change as you get older. But that doesn’t have to be a bad thing. Aging gracefully is about allowing the best version of yourself to shine through, and there are countless facial rejuvenation tools and treatments to help you do just that.

During our live chat on Tuesday, July 19th, Emory Aesthetic Center plastic surgeon, Dr. Felmont Eaves, answered all of your questions about helping to defy the aging process. Dr. Eaves discussed everything from skin care products to injectable treatments to cosmetic surgical options, such as Botox®, facelifts and eyelid lifts.

Below are just a few questions we were unable to respond to due to the large number of questions we received. For a full listing of questions and answers, please read our chat transcript. It is full of useful tips and answers that may be relevant to you. You may also visit emoryaesthetic.org for a full list of services and treatments offered by the Emory Aesthetic Center.

Question: How do I minimize dark circles beyond getting more sleep?

Dr. Eaves: There are two reasons that we may develop dark circles under the eyes. The first reason is that there is a dark tone to the skin itself. That is a difficult problem to treat, as currently we don’t have a great solution to dark circles. Sometimes bleaching creams containing hydroquinone can help, but that isn’t always successful. And chemical peels typically don’t work in this situation.

The other reason for dark circles, however, is the shadowing caused by bulging fat pads of the lower lids. Either surgery to remove or reposition the lower lid fat, or an injection of filler into the depressed area underneath the prominent fat – can soften or eliminate that shadow.

Question: What’s the best way to help with my lower face sagging without injecting a bunch of fillers?

Dr. Eaves: In the right patient, fillers can be great, but when the face truly begins sagging (not just deep folds by the mouth), then surgery is required to make truly significant changes. With a lower face lift (which typically includes tightening the neck as well) the jowls can be reduced, the cheek contours can be improved, and deeper folds/wrinkles around the mouth can be softened. It can provide dramatic, long lasting results, and recovery is generally relatively quick.

Question: How can you stop sagging eyelids?

Dr. Eaves: Sagging eyelids are generally treated with a blepharoplasty (an eyelid tuck and eyelid lift). Blepharoplasty can be used to treat the upper eyelids, the lower eyelids, or both, and are often combined with other areas of facial rejuvenation, such as a facelift, neck lift, and brow lift. Sometimes a sagging upper eyelid also has a component of malposition, where it isn’t just saggy skin. In those cases the lid can be repositioned while the blepharoplasty is being done.

Botox® for Men: Looking Good Isn’t Just for Women

Get rid of crow’s feet, a furrowed brow or sunken eyes in minutes. More men are using toxin injectables and fillers to look younger.Women aren’t the only ones who want to look better. According to the American Society for Aesthetic Plastic Surgery (ASAPS), men received nearly 600,000 injectable procedures (such as Botox® and fillers) in 2015.

If you’re a man who wants to look your best, clearly you’re not alone. Maybe it’s time to look for ways you can put your best face forward.

What are Injectables?

Injectables are cosmetic treatments that are injected into your body to improve your appearance without surgery. There are two types of injectables: neurotoxins (e.g. Botox®) and dermal fillers.

Neurotoxin Injectables

Neurotoxins  (also called toxins) are used treat deep lines caused by repetitive movements, such as smiling. Botox® is one of the most powerful neurotoxins in use today. Some people refer to Botox® to describe all cosmetic injectable treatments, but it only represents one substance.

This type of injectable is often used to treat:

  • Crow’s feet
  • Forehead wrinkles
  • Furrow lines between the eyebrows

It only takes minutes and you’ll have absolutely no downtime. You can expect to see full results in two to seven days. Results typically last three to four months and sometimes up to six months.

Dermal Fillers

There are different types of dermal fillers, but the most common contain hyaluronic acids (HAs). Fillers  add volume to address common aging problems like deep wrinkles, loss of fullness and sagging skin.

Fillers are used to treat:

  • Folds between the nose and lips (nasolabial folds)
  • Lips
  • Marionette lines (from corner of the mouth to the chin)
  • Sunken temples
  • Under eyes
  • Vertical lines around the mouth

Like injectables, fillers take just minutes, and you’ll see results right away. There may be a little bit of swelling and occasionally some light bruising. Typically, you can expect to get back to work the next day. The type of filler used and the area of the body it’s used on determine how long your results will last. For example, fillers in the folds around your mouth may last six to nine months, while fillers underneath your eyes may last a year or longer.

Who Should I Trust for Injectables and Fillers?

Don’t sacrifice quality for cost. The process seems straight-forward, but performing injectable treatment properly requires a great deal of skill and in-depth knowledge of facial anatomy. Look for a qualified cosmetic surgeon.

Thinking about Getting Injectables or Fillers?

Emory Aesthetic Center offers a variety of injectable procedures and other options to keep you looking your best.

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Or call us at 404-778-6880 to schedule your personal consultation

About Dr. Eaves

eaves-iii-felmontDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

His professional and institutional committee memberships and offices include an impressive list of national, international and local plastic surgery organizations, societies, boards, task forces, advisory councils, coalitions and foundations, including having served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2010-2011 and Trustee (2011-Present).

Dr. Eaves’ primary areas of academic inquiry have been in minimally-invasive and endoscopic aesthetic surgery, patient safety, system and process improvement in plastic surgery, evidence-based medicine applied to plastic surgery and recontouring surgery after massive weight loss. He has received several patents for new medical devices he developed, and has made major clinical service contributions to his field. Dr. Eaves has published more than 100 articles, book chapters and book reviews on plastic surgery in peer reviewed publications, as well as manuals, videos, computer programs and other teaching aids and has coauthored the first textbook on the topic of endoscopic plastic surgery.

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Facial Rejuvenation- Secrets to Defying the Aging Process

Learn the secrets to defying the aging process with facial rejuvenation. Renew your face with tips from a board-certified cosmetic surgeon.Aging is a part of life. And yes, your appearance will change as you get older. But that doesn’t have to be a bad thing. Aging gracefully is about allowing the best version of yourself to shine through, and there are countless facial rejuvenation tools to help you do just that.

Facial Rejuvenation Starts with Skin Care

Skincare is the first and most important step of facial rejuvenation. You don’t need to ditch your current products and spend a fortune on complete skin care “systems” to get good results.

A licensed aesthetician can help. Find someone who’s willing to listen to your concerns and offer advice to help you get the results you want within your budget.

These products can help you look your best:

• Sunscreen. Use sunscreen every day to prevent aging sun damage, such as dark spots and fine lines.
• Vitamin C. Apply Vitamin C to your skin to reduce the effects of sun damage and significantly brighten your complexion.
• Tretinoin (Retin-A). Use a Retin-A product to penetrate the deeper layers of your skin and stimulate collagen production. It also works as a mild daily exfoliant.
• Prescription medicine. Ask a dermatologist about certain prescription medicines (such as hydroquinone), which can lighten dark brown spots, patches and hormone-induced darkening.

Chemical Peels and Micro-Needling

Minor procedures for facial rejuvenation such as mild to medium facial peels (also known as chemical peels) and micro-needling can do wonders to kick-start a healthy routine and help your skin care products to work even better. Regular peels can help keep your skin texture looking younger as you age.

Injectable Treatments

You may get great results from fillers and/or Botox© if you have these early signs of aging:

• Mild volume loss
• Fine, early creases around your forehead and/or between your eyes
• Crow’s feet

Most patients have more than one of these signs, plus others such as loose skin and fat build up. You may need a multi-step action plan for facial rejuvenation to tackle multiple concerns.

Cosmetic Surgery

If you’re trying to use fillers or Botox for something that really requires cosmetic surgery, you probably won’t be happy with the results.

For example, if you have extra skin or fat around your eyelids and use Botox to lift your eyebrows, you may end up with an unnatural, arched expression. If you use an injectable filler to add a significant amount of volume to your jawline, you may look more “puffy” than youthful.

There are many surgical procedures that can help you put your best face forward. Talk to a board certified cosmetic surgeon to learn which procedures may be right for you.

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Or call us at 404-778-6880 to schedule your personal consultation

About Dr. Sethna

anita-sethna-avatarDr. Sethna understands that facial plastic and reconstructive surgery demand a marriage of science and artistry, and she enjoys using precision, skill, and vision to make her patients’ dreams reality. Dr. Sethna’s meticulous attention to detail and her passion for maintaining a natural look ensure optimum results for her patients.

A dedicated teacher, Dr. Sethna is devoted to assisting residents in facial trauma or reconstructive cases at Grady Hospital. She relishes the opportunity to educate residents and medical students in all aspects of patient care. Dr. Sethna has a strong interest in several areas of facial plastic surgery research and has presented at national meetings on the importance of resident and fellow education in rhinoplasty techniques and adjunctive measures to decrease discomfort during cosmetic procedures.

Takeaways from the Emory Aesthetic Center’s Getting Ready for the Holidays Live Chat

eac-holiday-260x200Thank you to everyone who joined us on Tuesday, October 13th, for our live online chat on “Getting Ready for the Holidays”, hosted by Emory Aesthetic Center’s facial plastic surgeon, Dr. Anita Sethna.

Believe it or not, the holidays will be here before we know it. In this live chat, Dr. Sethna provided advice and answered questions on how to get your skin glowing for the festive season. She discussed effective non-surgical treatments that will give you a brighter, rejuvenated look. She also answered questions around cosmetic surgical options and recovery to ensure your are ready just in time for the season. Here are just a few highlights from the chat, including one question we didn’t have a chance to answer:

Question: Can you perform a nose job with injections? My friend said that he had it done and I can see a difference.

anita-sethna-avatarDr. Sethna: Non-surgical rhinoplasty is a relatively new concept in injectables, but not one that should be taken lightly. There are no FDA-approved injectables for injection into the nose. That being said, in very select cases either after a rhinoplasty has already been done, or if a small issue in the bridge needs to be corrected, injection of a hyaluronic acid filler (juvederm , restylane for example) can be injected to correct the concern. A rhinoplasty surgeon familiar with the anatomy and blood vessels of the nose should be the one performing the injection. The risks of improper placement or unintended consequences can be severe in the nasal skin if performed by an untrained individual. As always, a consultation with a rhinoplasty expert to determine whether your concerns are even amenable to non-surgical (injectable) rhinoplasty is recommended prior to any interventions.

Question: What is the simplest thing someone can do to look fresher and rejuvenated?

anita-sethna-avatarDr. Sethna: On a daily basis, skin care is probably the easiest and biggest bang for your buck. The ingredients that are most helpful are tretinoin, or some type of retinol, that is essentially a daily exfoliant that is helpful in stimulating collagen and removing surface dead skin cells.

 

 

Question: When would you recommend a chemical peel and what does it best treat? Wrinkles? Complexion? Wondering if I should have one.

anita-sethna-avatarDr. Sethna: There are many different types of chemical peels and many different concentrations that can be used to achieve a different type of cosmetic result. Very limited amount of down time can be achieved with a lower concentration of peel solution and can improve overall brightness of the complexion and possibly improve the appearance of darker spots or age spots. If deeper wrinkles are present or overall skin tightening is desired, most of the time a deeper peel will need to be performed in an operating room or under sedation, with a recovery time of closer to seven days. Most peels can be repeated to get more drastic results and can be repeated with varying intervals depending on the depth of the original peel. Ultimately, the best recommendation on whether or not it will be helpful will be to come in for a consultation to address what your overall goals are and whether a peel could accomplish those.

If you missed out on this live chat, be sure to check out the full list of questions and answers on the chat transcript. You can also visit emoryaesthetic.org for a full list of services and treatments offered by the Emory Aesthetic Center.

If you have additional questions for Dr. Sethna, please feel free to leave a comment in our comments area below.

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or call us at 404-778-6880 to schedule a consultation.

How to Prevent and Treat Crows Feet

happy-ladyCrow’s feet, or laugh lines around the eyes, can be a challenging area to treat from a cosmetic perspective. On one hand, expressions of joy transmitted through the eyes are beautiful in their own right, but deeper lines and creases in this area can often draw attention to the changes associated with aging and loose skin.

My personal approach is to attempt as much as possible to prevent the lines from becoming deep, or in some cases, even forming to begin with. There are two main methods to achieve this – skincare to plump and stimulate collagen (such as tretinoin or Retin-A©), and Botox® (or equivalent Xeomin® or Dysport®) to reduce the muscle movement in the area and thereby reducing crease patterns. These options can be started at any time, even in the early 30s before real creases have begun. A combination of treatments early can prevent the formation of obvious deeper creases. At this stage, Botox can be performed as little as twice a year before creases have actually formed.

Once the creases are present, the above combinations of skincare and Botox can still make a significant impact and can lessen the appearance of lines around the eyes. Often, this is all that patients are interested in so that they can still appear to have movement while improving their overall appearance. If a more drastic improvement is needed, a series of peels or even fractional laser treatments can be undertaken. The choice of intervention depends on the comfort level of the surgeon and the amount of downtime or recovery the patient is able to give.

If a week of downtime is tolerable, fractional laser resurfacing can be performed relatively aggressively to specifically treat the area around the eyes. Makeup can typically be worn to reduce the appearance of redness during the recovery period. Because we usually cannot be aggressive enough with one treatment to wipe out these lines, a repeated treatment may be needed 3-6 months later. During that period of recovery, Botox can be used to give the skin a continued break from creasing as well.

Facial peels can also be performed, often at varying depths, depending on the amount of recovery or downtime afforded. Often, a peel will have 3 days of recovery and can be repeated every 4 to 6 weeks for a total of 3 to 4 treatments to allow improvement in this area. It is a slower, but less intensive treatment plan. Continuing skincare and Botox through this period will also boost results.

All in all, a multi-pronged approach is often needed to treat the eye area. The good news is that crow’s feet respond to treatment quite well if all options are utilized. Other treatments, such as fillers, can be used as well if indicated, but are not routine as they can be fraught with unexpected complications. With judicious use of Botox and a rigorous skincare routine early, an ounce of prevention is definitely worth a pound of cure.

Come meet with one of the board-certified physicians of the Emory Aesthetic Center. We can discuss your goals and determine what combination of treatment is right for you.

appt

or call us at 404-778-6880 to schedule a consultation.

About Dr. Sethna

anita-sethna-avatarDr. Sethna understands that facial plastic and reconstructive surgery demand a marriage of science and artistry, and she enjoys using precision, skill, and vision to make her patients’ dreams reality. Dr. Sethna’s meticulous attention to detail and her passion for maintaining a natural look ensure optimum results for her patients.

A dedicated teacher, Dr. Sethna is devoted to assisting residents in facial trauma or reconstructive cases at Grady Hospital. She relishes the opportunity to educate residents and medical students in all aspects of patient care. Dr. Sethna has a strong interest in several areas of facial plastic surgery research and has presented at national meetings on the importance of resident and fellow education in rhinoplasty techniques and adjunctive measures to decrease discomfort during cosmetic procedures.

Ensuring Safety with Dermal Fillers and Botox

botox-injectionWith the prevalence of advertising injectables, and with specials running on every corner, it can be difficult to make a decision regarding where, when and who should be performing your nonsurgical facial rejuvenation.

The most common question I get from my patients is whether or not Botox® and dermal fillers are safe to use in the long-term. This is a reasonable question – after all, there is no shortage of exposures these days that we later discover have been harmful to us all along. But I reassure my patients that Botox (and its counterparts, Dysport© and Xeomin©, which I will refer to under the heading of Botox for simplicity) has been used in the treatment of facial wrinkles since the 1980s and 1990s – although it was only approved in 2002 for cosmetic use. We have therefore been watching the effects and risks of this potent and effective treatment for over 30 years now. There are also few other medications that have been studied quite as much as Botox for both cosmetic and non-cosmetic uses.

Dermal fillers, you may be surprised to know, have been used in their collagen form since the 1980s. The problem with using collagen fillers was that it required allergy testing and the effects of the filler only lasted about 3 months. With the onset of hyaluronic acid fillers, and some of the other longer lasting options available, results can last from months to years depending on the type and placement. Hyaluronic acid options are generally considered extremely safe, as this is a component of our own cellular structure and therefore does not require additional allergy or skin testing. It also has an excellent safety profile because it can be dissolved if the need arises by injecting an enzyme that breaks up the filler.

The issues of primary importance when you are contemplating who or where to have your treatment are the experience of the injector and where the product is obtained. Reputable physicians and surgeons will obtain the product directly from the manufacturer, not a discounted offshoot. There is little the consumer can do to ensure this other than to ask if the product has been obtained from the manufacturer and not a third party. This guarantees the product is pure and sterilely packaged.

The other issue is to have your treatments performed by someone who is comfortable not only with the methods and materials, but someone who has experience dealing with complications. Botox used for cosmetic purposes has risks of local bleeding or bruising, and diffusion into surrounding structures. This can lead to eye drooping or changes in mouth position if injected in these areas. In most cases, for cosmetic uses, the risk of breathing difficulty or swallowing problems does not reasonably occur.

Fillers can carry other risks. As with Botox, some of the common risks are bleeding and bruising. These are temporary and most often do not interfere with the final result. However, fillers should be considered an injectable implant. Sterile technique should always be used – cleaning the face with alcohol to remove all makeup, avoiding touching of the face after preparation and keeping needles and products packaged sterilely until use. Local infections can occur and can result in delayed results or other complications if sterile technique is not used.

Finally, injections of foreign materials into blood vessels can be dangerous and can cause changes in the surrounding tissues in a dramatic way. This can, in many cases, be avoided with proper attention to the anatomy of the face and knowledge of safe areas to inject fillers. Notably, in the U.S., silicone is not FDA-approved for soft tissue injection. Make sure to ask your injector if the product that is being recommended is FDA-approved for facial injection and whether there are specific risks associated with these injections. You can also ask if they can be reversed if a poor outcome or complication occurs. You should always be asked to sign a consent form prior to injection of a new product. Please take the time to read the consent forms. Many patients feel that since these products can be obtained at a spa or without “surgery”, the risks are minimal and not worth reading about in detail. Injectables are still elective procedures and carry risks associated with them. Make sure you understand what the risks are before embarking on this journey.

The overwhelming majority of patients obtaining Botox or dermal fillers are exceedingly pleased with their results. The risks of some of the more worrisome complications is quite low – 0.0001% in some of the available literature. Once you are aware of the possibilities, you are an informed consumer. Be sure to ask questions of your injector and preferably consult a surgeon familiar with the anatomy and soft tissues of the face that utilize injections in their practice on a daily basis. Injectable treatments can be powerful tools for nonsurgical facial rejuvenation with tremendous success.

Let the board certified physicians of the Emory Aesthetic Center provide you with a complimentary consultation to assess your needs and help you think through the options. We will help choose an approach personalized to you and your needs.

404-778-6880
emoryaesthetic.org
Click here to schedule your personal consultation.

 

About Dr. Sethna

anita-sethna-avatarDr. Sethna understands that facial plastic and reconstructive surgery demand a marriage of science and artistry, and she enjoys using precision, skill, and vision to make her patients’ dreams reality. Dr. Sethna’s meticulous attention to detail and her passion for maintaining a natural look ensure optimum results for her patients.

A dedicated teacher, Dr. Sethna is devoted to assisting residents in facial trauma or reconstructive cases at Grady Hospital. She relishes the opportunity to educate residents and medical students in all aspects of patient care. Dr. Sethna has a strong interest in several areas of facial plastic surgery research and has presented at national meetings on the importance of resident and fellow education in rhinoplasty techniques and adjunctive measures to decrease discomfort during cosmetic procedures.

How To Get Cosmetic Surgical Results Without Surgery

natural-beautyNo one really wants to have surgery if they don’t need it; therefore, it isn’t surprising that cosmetic surgeons are asked quite often how someone can get surgical results without actually having surgery. Well, it certainly sounds good . . surgical results without surgery, right? The problem is that it really doesn’t work that way. The long and the short of it is in order to get the dramatic results of surgery, you have to have surgery. But with all of the new non- and minimally-invasive treatment options that have become available in recent years, the answer isn’t always so cut and dry, and there are options. It is not a matter of good versus bad, but really understanding the differences between the surgical and the non-surgical options, and figuring out which one is going to best help you achieve your goals.

The facial region is the area with the greatest number of non-surgical options, from Botox® to dermal fillers and chemical peels to lasers and micro-needling. Non-surgical treatments can be quite effective in the face when you are treating the right problem. Botox® does a wonderful job of temporarily softening wrinkles in the forehead, between the brows, and the sides of the eyes. Dermal fillers can plump up the cheeks and minimize creases around the mouth. Skin products, in-office chemical peels, Intense Pulsed Light (IPL), micro-needling, and lasers can do a superb job of improving the fine wrinkles, texture, and pigment in the skin. However, if you are looking to reduce the jowls, tighten the neck or lift droopy brows or eyelids, then non-surgical treatments won’t provide the results that you seek. It is extremely common patients will undergo a blend of surgical and non-surgical procedures to take advantage of the strengths of both. In younger patients who are not yet ready for surgery, non-surgical options may provide them exactly what they want.

For breast augmentation, the surgical versus non-surgical comparison doesn’t work, because there really aren’t non-surgical options to do the things that patients want. At the present time you can’t increase the breast size, reduce the breast size, or lift up drooping breasts without surgery. In the breast, though, the discussion is often around full length or reduced incision approaches. Like non-surgical treatments, reduced scar approaches sound really positive – and of course who wouldn’t want that? However, in some cases a full scar approach is required to get the degree of results that a patient wants or needs.

Only recently have significant non-surgical options emerged for treatment of the abdomen, flanks, and thighs. These treatments are directed at two primary goals – reducing the fatty layers and tightening the skin. Infrared therapy, external ultrasound, and cryolipolysis (fat freezing) are all energy devices approved to reduce the thickness of the fatty layer. CoolSculpting® is a fat freezing treatment currently available, and it is the treatment that we have chosen to offer at the Emory Aesthetic Center due to the level of comfort experienced by patients and the medical studies that support its use. But not all patients get the results that they seek. And while a few patients don’t seem to achieve much of a result, a small number of patients are “super-responders” who can get a dramatic result, sometimes with just one treatment. But overall, most patients will see a 10-20 percent improvement in an area with a single treatment, but for additional improvement they will need repeat treatments. Liposuction is the surgical counterpart to fat freezing. Not surprisingly, liposuction allows us to treat more areas at a time, be more aggressive in fat removal, and depending on the number of areas to treat and the number of CoolSculpting® sessions, sometimes liposuction can be less expensive as well.

At this point, non-surgical treatments seem to do a better job at fat removal than skin tightening. For this reason, there isn’t much in the way of non-surgical options for patients that may have significant skin laxity, for example when they need a tummy tuck or thigh lift. In these instances, surgical resection can be combined with liposuction to not only tighten the skin, but to sculpt the tissues as well. It is because of this combined strategy that tummy tucks, for instance, can produce some of the most dramatic improvements of any of the surgeries that plastic surgeons perform. However, if a patient is young and has generally good skin quality, with limited fatty deposits, fat freezing without the need for surgery can be a great option.

To pull it all together, there are some things that surgery can do that non-surgical treatments simply can’t do. In other cases non-surgical treatments can be highly effective and can provide for you the results you want – without the need for a surgical procedure or significant recovery period. What is best for you depends on your specific appearance, your tissues, and your goals. At the Emory Aesthetic Center, we are happy to be able to offer the entire spectrum of surgical and non-surgical options. Our board-certified physicians can work with you to determine the best solution for you and your desired result.

404-778-6880


emoryaesthetic.org


Click here to schedule your personal consultation.

About Dr. Eaves

eaves-iii-felmontDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

His professional and institutional committee memberships and offices include an impressive list of national, international and local plastic surgery organizations, societies, boards, task forces, advisory councils, coalitions and foundations, including having served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2010-2011 and Trustee (2011-Present).

Dr. Eaves’ primary areas of academic inquiry have been in minimally-invasive and endoscopic aesthetic surgery, patient safety, system and process improvement in plastic surgery, evidence-based medicine applied to plastic surgery and recontouring surgery after massive weight loss. He has received several patents for new medical devices he developed, and has made major clinical service contributions to his field. Dr. Eaves has published more than 100 articles, book chapters and book reviews on plastic surgery in peer reviewed publications, as well as manuals, videos, computer programs and other teaching aids and has coauthored the first textbook on the topic of endoscopic plastic surgery.

Facial Rejuvenation: Temporary versus Long Lasting Effects

temporary-vs-permanentLike most things in life, when considering a cosmetic procedure to rejuvenate the face, there are many things to take into account. For instance, some procedures are less invasive and have minimal recovery time; others are much more invasive and may require several weeks to fully recover. There is also the cost factor to think through as well. The right procedure for you will depend on many of these factors, along with the goals that you have.

For most patients, this comes down to a question of “Do I need surgery, or will non- (or minimally) invasive procedures give me the results that I’m looking for?”. There is no doubt that non-invasive or minimally-invasive procedures are inherently attractive as an option. They usually offer minimal or short-term discomfort, there are no scars to heal and fade, and patients don’t generally have significant bruising or swelling. Also, the cost of a single minimally invasive treatment is usually significantly less than that of a more aggressive, comparative surgical procedure. Examples of minimally invasive treatments include injectables like Botox© and dermal fillers, lasers and Intense Pulsed Light therapy, high grade skin care products, and skin treatments like chemical peels, facials, or micro-needling. These are some of the most common treatments performed in aesthetic centers.

So with all these great attributes and options for minimally invasive treatment, why do patients still often choose surgery? There are several reasons.

First, minimally invasive treatments are usually temporary. For example, Botox© (and similar products such as Xeomin© and Dysport©) do a great job of relaxing the muscles that create the wrinkles between the eyebrows (“the 11’s”), across the forehead, and in the corners of the eyes (“crow’s feet”). However, these muscle relaxers typically work for 3-4 months and then the effect wears off. This requires the patient to come back to the office for repeat injections. Dermal fillers typically last longer. Depending on the type of filler and the area treated, effects may last anywhere from six months to a couple of years. Some patients simply prefer something more permanent, and they want to avoid repeat treatments.

A second reason is that some aging changes cannot currently be corrected by anything but surgery. Examples include the development of jowling or of significant skin looseness in the neck area. Although some companies might hawk a magic cream or energy device to handle these kinds of issues, these don’t really work and the solution is a facelift (which includes lifting the neck). A facelift can dramatically improve these areas, and the results last for many years. Other examples of changes that require surgery as opposed to non-surgical treatments include significant droopiness of the brows or eyelids.

As plastic surgeons, we are reluctant to call the results of facial rejuvenation surgery “permanent,” although in many ways they are. Let’s say a patient undergoes a facelift and loves the improvement in skin tightness, the jowls, the neck contour, and the folds around the mouth. Once healed, these results will look good for many years. However, over the course of these years, the aging process will continue – skin will become more lax, and tissues may start to droop a bit. At some point, typically after 7-10 years or more, the patient may want to undergo additional surgery to treat these changes. But even at ten or more years after surgery, results are better than they would have been without surgery in the first place. The tendency for some recurrence over time varies by the different area of the face being treated. Brow lifts, upper eyelid tucks, and the neck portion of a facelift tend to last a long time and require repeat surgery less often, or never. Some recurrence of laxity in the lower face, however, is more common. Therefore, many patients may consider a secondary face lift 7-10 years or more after their first procedure. Of note, this secondary procedure may not need to be as extensive as the first procedure.

A third consideration is cost, and there is no doubt that surgical procedures typically cost significantly more in the short term. However over the years the cost of maintenance by means of repeated non-invasive treatments will continue to rise, often to the point that surgery can be far cheaper in the long run.

Finally, it is very helpful to think about temporary (typically minimally invasive) treatments and long lasting treatments (typically surgery) not as an “either or,” but as a “yes, and”. In other words, many patients benefit from both. For younger patients who are not yet ready for surgery, the less aggressive and temporary treatments are an ideal option. For older patients who are undergoing surgery, minimally invasive treatments can enhance and help maintain their results. It is extremely common that we “mix and match” various surgical and non-surgical procedures to offer patients the combination of treatments that will give them the best results.

If you are wondering about temporary versus long lasting treatments, and non-surgical versus surgical, the board certified physicians at the Emory Aesthetic Center can perform a comprehensive skin and anatomical assessment, and can help you think through the options and choose an approach personalized to you and your needs.

 

404-778-6880
emoryaesthetic.org
Online personal consultation request: http://www.emoryhealthcare.org/cosmetic-aesthetic/appointment.html

About Dr. Eaves

eaves-iii-felmontDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

His professional and institutional committee memberships and offices include an impressive list of national, international and local plastic surgery organizations, societies, boards, task forces, advisory councils, coalitions and foundations, including having served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2010-2011 and Trustee (2011-Present).

Dr. Eaves’ primary areas of academic inquiry have been in minimally-invasive and endoscopic aesthetic surgery, patient safety, system and process improvement in plastic surgery, evidence-based medicine applied to plastic surgery and recontouring surgery after massive weight loss. He has received several patents for new medical devices he developed, and has made major clinical service contributions to his field. Dr. Eaves has published more than 100 articles, book chapters and book reviews on plastic surgery in peer reviewed publications, as well as manuals, videos, computer programs and other teaching aids and has coauthored the first textbook on the topic of endoscopic plastic surgery.

Can Men Get Plastic Surgery?

guysAt the Emory Aesthetic Center, we have traded in our Cosmopolitan subscription and replaced it with Sports Illustrated. Why? It’s simple. Plastic surgery is no longer just for women.

Today, we are seeing more and more men of all ages requesting plastic surgery for cosmetic reasons. We’ve discovered that men are just as worried about their appearance as women. But it is important to know that men’s needs may be different, as most cosmetic procedures have been designed with women in mind. Factors to consider include skin thickness, beard growth, and body type.

Let’s review the top plastic surgery procedures men are requesting by the numbers.

Face-Lift/Neck-Lift
Results last: 10 to 15 years
Recovery: 7-10 days
Cost: $12-14,000

Eyelid Lift
Results last: 15 to 20 years
Recovery: 7-10 days
Cost: $6-8000 for upper and lower (half of that for just upper)

Body Liposuction
Results last: Depends on maintaining a healthy lifestyle and weight
Recovery: 1-2 days
Cost: minimum $4500-unmlimited based on areas treated

Breast Reduction
Results last: Permanent
Recovery: 2-3 days
Cost: $8-10,000

Rhinoplasty
Results last: Permanent
Recovery: 5-7 days
Cost: $7-9,000

Botox®
Results last: 6 to 9 months
Recovery: 0 days
Cost: $300-600 per treatment

Dermal Fillers
Results last: 1 to 2 years
Recovery: 1-2 days
Cost: $450-800 per syringe

At the Emory Aesthetic Center, our board-certified physicians understand that the delivery of plastic surgery is different for men than women. We will approach your individual goals with personal attention and help you choose the procedure that is right for you.

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About Dr. Anderson

Erica Anderson, MDErica Anderson, MD, is board certified by the American Board of Plastic Surgery and currently holds an appointment as Assistant Professor in the Division of Plastic Surgery at Emory University. Dr. Anderson completed her general surgery residency and plastic surgery residency at the University of Colorado Health Sciences Center and associated hospitals in Denver, CO. She completed a year of advanced training in Aesthetic Surgery at Grotting Plastic Surgery in Birmingham, Alabama.

Dr. Anderson returns to Emory University after being in private practice in Arlington, Virginia. While there, she maintained a busy aesthetic and reconstructive practice and also served as Medical Director for the Wound Healing and Hyperbaric Center at Virginia Hospital Center.

Dr. Anderson’s academic and research interests are largely focused on clinical outcomes with regards to cosmetic surgery. Her areas of clinical interest are diverse including cosmetic surgery of the breast and body as well chest wall reconstruction and wound care.

Dr. Anderson is married with 3 children, Trent, Connor and Fiona, and 2 vizslas, Max and Mimi.

Ask the Doctor: How Does Botox© Work?

Botox Before and AfterBotox©, or botulinum toxin, is an injectable medication that stops muscles from moving over a short-term period, usually 3-4 months. In order for muscles to move, they must receive a signal, a chemical transmitter, which attaches to a receptor on the muscle and gives it the signal to contract. Botulinum toxin stops the release of that transmitter, so the muscle cannot move. In nature, though rare, this toxin is considered one of the most deadly toxins, because it can cause the muscles that help you breath to stop working. Over time, and after having been studied and perfected for almost 50 years now, Botox has become the number one cosmetic treatment the world over. Injected in very small doses, this medication can not only treat lines and wrinkles around the forehead, between eyes and the crows feet, but can also prevent the formation of new ones!

Botox is not only a cosmetic treatment, however. The first uses for Botox were for an eye muscle condition called strabismus. Spasms of the eye, migraines, large muscle movement disorders and voice tremors can also be treated with this effective and life-impacting drug.

The indications, both FDA-approved and not approved, for this medication are ever increasing. The key, however, is to ensure your treatment is performed in the very safest way possible. In order to save money, patients may frequent medical spas, attend “Botox” parties, sign up at dental offices, or other non-surgical specialties, thinking Botox at one place is the same as any other. In truth, the risks of having an injection into the wrong muscle group, or at too high a dose, can be far too great to engage in this type of cost cutting.

Make sure you undergo your injections with a board-certified cosmetic surgeon who performs injections on a regular basis, and has the understanding of underlying facial and neck musculature before undergoing treatment. Ask any questions that may concern you prior to your treatment as well as noting any precautions for after being injected. Botox is one of the most-studied medications we use today and has positively impacted the lives of many patients, both cosmetic and otherwise. When used safely, the vast majority is extremely pleased and loves their fresher and more youthful appearance.

If you are considering Botox©, or facial fillers, let the board certified physicians of the Emory Aesthetic Center help you decide what treatment is best for you.

404-778-6880
emoryaesthetic.org

About Dr. Sethna

Anita Sethna, MDAnita Sethna, MD, understands that facial plastic and reconstructive surgery demand a marriage of science and artistry, and she enjoys using precision, skill, and vision to make her patients’ dreams reality. Dr. Sethna’s meticulous attention to detail and her passion for maintaining a natural look ensure optimum results for her patients. A dedicated teacher, Dr. Sethna is devoted to assisting residents in facial trauma or reconstructive cases at Grady Hospital. She relishes the opportunity to educate residents and medical students in all aspects of patient care. Dr. Sethna has a strong interest in several areas of facial plastic surgery research and has presented at national meetings on the importance of resident and fellow education in rhinoplasty techniques and adjunctive measures to decrease discomfort during cosmetic procedures.