Dermal Fillers

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.

 

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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.

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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.

What Are Dermal Fillers and How Do They Work?

Dermal FillersThe world of facial injectables and dermal fillers can be overwhelming with all the options seen in print and TV ads. The biggest breakdown in classes of injections are between Botox® and it’s counterparts, Dysport® and Xeomin®, (hereby referred to as “neuromodulators” because they affect muscle nerve endings) and dermal fillers such as Juvederm®, Restylane® and Radiesse®. While neuromodulators are best used to affect lines caused by repetitive muscle motion, facial fillers are best used to enhance areas of low volume or deeper folds that are present at rest. For a straightforward example, frown lines between the eyebrows, crows’ feet outside the eyelids, and lines on the forehead are ideal for neuromodulator injections because these are due to motion. Decreased volume in the lips, smile lines around the mouth, or decreased volume in the cheeks is best treated with fillers to improve volume and support soft tissue.

There are many different types of fillers available in the United States. Some are permanent, such as Artefill, but most are absorbed into your body over time. The vast majority of commonly used absorbing fillers are composed of a material called hyaluronic acid, which is part of the normal makeup of our skin. Because of this, it is easily tolerated by the body and rarely has the adverse side effects that are associated with previously used collagen fillers. The hyaluronic acid fillers that are most used include: Restylane®, Juvederm® (including Ultra and Ultra Plus), Voluma®, Prevelle Silk, Belotero® and Perlane to name a few. Some of these are available premixed with lidocaine, a local anesthetic, to minimize discomfort associated with injection.

Radiesse®, also a commonly used filler, is made of a material called calcium hydroxyapatite. It is also dissolving but tends to be thicker in composition and is only injected deeper to avoid risks of visibility or lumpiness.

Sculptra, also categorized as a filler, is best thought of as a collagen-stimulator. This is intended for patients who need larger areas of gradually increasing, more subtle volume. Because of the composition of Sculptra, it is hydrated with water for 48 hours before injecting, and then it is injected in small doses throughout the tissues under the skin. The process of volumizing takes up to six weeks for each vial injected, with the recommendation of at least 3 vials to get to full correction per area treated.

So how do you determine the ideal filler for the area you are interested in treating? The best answer is to consider carefully what areas are most bothersome to you and make an appointment for consultation with a board-certified Facial Plastic or Plastic Surgeon with experience treating the face. Depending on the area of concern, the depth of the issue and the thickness of the material, your surgeon will determine the best product for injection. Each of us has cultivated years of experience with many of the fillers available on the market, and we have individual preferences based on those experiences. Feel free to ask questions, return for a second discussion or look at photos if you deem it helpful. Ultimately, what all of us want is a happy patient, so make sure your desires are communicated effectively to ensure your best result.

The board-certified cosmetic surgeons of the Emory Aesthetic Center can evaluate and work with you to develop a plan that is tailored specifically to your desires and needs.

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.

Skin Care throughout the Stages of Life

Skin Care StagesOne thing my experience as an aesthetician for over twenty years has taught me is that each client/patient has individual cosmetic concerns and needs. As you age, as seasons change, and as you go through different transitions of life, your skin will change as well. It is important to have a relationship with an aesthetician so that he/she can help you look your best through every phase of your life. As skincare specialists, we are trained to provide the proper treatments and ingredients to your skin to allow it to be at its optimal health. Below are some general skincare guidelines we recommend for the different stages of life:

  • In your thirties it is time to get serious about your skin care. Stop using bar soap on your delicate skin. Now is the time to begin using a facial cleanser morning and night. It is imperative to wear sunscreen daily with an SPF of 30 or higher – be sure to look for one that has a blend of antioxidants and moisture. For night, we recommend using a light moisturizer containing antioxidants, retinol or Alpha Hydroxy Acid (AHA) to give your skin the help it needs to stay rejuvenated.

Having regular facials every six to eight weeks will help keep the pores clean and hydrate the skin. Also, microdermabrasion is a great way to have your skin exfoliated and give it a very refined and polished look.

With our doctors, Botox®  may be a consideration if you are starting to see fine lines around the eyes and forehead.

  • In your forties you need to step up the game on your skin care. It is time for more advanced active ingredients. You will find these products at your cosmetic surgeon or dermatologist office. It is time to utilize the assistance of a skin care specialist to recommend proper products based on an evaluation of your skin. Washing your face with a cleanser containing AHA will help with exfoliating the skin to give it a nice glow. Using an antioxidant serum like will fight against the free radicals we expose our skin to everyday. Regular use of prescription grade retinol or tretinoin will boost collagen and elastin, as well as help to slow down the hands of time.

Intense Pulse Light (IPL) is a wonderful in office treatment that can assist in removing unwanted brown spots and broken blood vessels caused by sun damage. Medium depth facial peels are also an option to help give the face a lighter, brighter, and more supple appearance.

With our doctors, dermal fillers such as Restylane® , Juvederm®  and Voluma®  can be added to the face to help soften fine lines around the mouth and other areas of the face where needed. Botox®  can soften the appearance of lines around the eyes and forehead. Deeper chemical peels performed in the operating room are done for more advanced sun damage.

  • In your fifties it’s time to fight back the hands of time. Keep in mind that at this stage the skin is dryer and more fragile. Wash your face with a gentle hydrating cleanser morning and night. Never forget your daily sunscreen with an SPF of 30 or higher. Use products with DNA repair, growth factors and stem cells that will help trigger new cell growth. Make sure to continue your prescription retinol or tretinoin to slow down the aging affects. Always use night creams rich in hyaluronic acid that will help retain moisture in your skin.

Fractional Resurfacing is a noninvasive laser treatment that can help in smoothing fine lines and wrinkles. It can assist in tightening the face and neck multiple treatments are required for best results. Intense pulse light can help the appearance of rosacea and brown spots caused by the sun. Micro-needling with a growth factor is also a great choice to help stimulate collagen production in the skin. We recommend facials every four to six weeks to help with hydration and circulation.

It may be the time to build a relationship with a cosmetic surgeon to weigh the options of a liquid facelift using dermal fillers and Botox®  injections versus taking the plunge and having surgery. Finding a physician that you trust and feel 100% confident in is very important. Take the time to get to know your surgeon so that if and when you make the decision to have surgery you will be comfortable with your choice.

  • In your sixties your skin may be much more sensitive so protection and hydration is very important. Use gentle cleansers to wash your face morning and night. Wear a sunscreen with an SPF 30 or higher daily. Using antioxidants and hyaluronic acid will help protect and hydrate the skin. Using a mild exfoliate once a week will help give your skin a nice glow. Using products with DNA repair, growth factors and stem cells will help trigger new cell growth. Applying moisturizers with ceramides will bring long lasting hydration to the skin.

Having facials on a regular basis will ensure hydration and stimulation for your skin. Hydrafacials are a wonderful way to gently exfoliate the skin and infuse the face with antioxidants and hyaluronic acid using a special machine that helps penetrate deep into the skin. For an overall rejuvenation to tighten the skin, regain elasticity, minimize pores, and soften fine lines and wrinkles, we recommend micro-needling.

With our doctors, deep chemical peels can soften or remove lines and wrinkles around the mouth and tighten the skin. Botox®  and dermal fillers are a great non-surgical way to plump up thin lips, fill the lines around the mouth and soften the lines around the eyes and forehead. Discuss surgical options with your physicians if you considering facial surgery.

Call today for a complimentary skincare consultation with one of our licensed aesthetician at the Emory Aesthetic Center Spa.

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From Face to Breast to Body: Understanding Aesthetic Surgery

Understanding Aesthetic SurgeryThere is a deep and rich science related to the understanding of the origins, importance, and impact of physical appearance on our lives. Research tells us that as human beings our appearance not only plays a role in how we view ourselves, but it also plays a role in our interaction with the world. Therefore, it is not surprising that in addition to grooming, makeup, and exercise, cosmetic procedures and surgeries have become a popular option to millions of women and men every year.

Although we don’t consciously think of beauty in this way, science teaches us that there are four primary ways in which we care about our appearance. They are youthfulness, symmetry, gender, and normal development. If we think in these terms, it becomes easy to understand that aesthetic surgery of the face, breasts, or body is similar and follows similar patterns.

For instance, as we age our skin and soft tissues loose tone and elasticity. In the face we see it with loose skin, the development of wrinkles, and by tissue drooping. These same kinds of changes can also lead to drooping of the breasts, abdominal skin, and bottom. The most common way to reverse these changes is to “lift” loose tissues. “Lifting” can actually mean pulling up an area, but it can also mean tightening the area by removing some of the loose skin and tissue, so that what is left is pulled tighter. Lifting is a common technique that is used in the face (think brow lift, eyelid lift, or neck lift), breasts (breast lift), and body (think body lifts – tummy tucks, thigh lifts, buttock lifts). Pulled tighter, the lifted area looks more youthful to us.

Youthfulness also correlates with a more fit, athletic appearance, so it is not surprising that fatty deposits bother us, whether it is under the chin, in the “bra roll” area adjacent to the breasts, or on our tummies or thighs. When we can’t fix these areas in the gym, perhaps we can help them with a surgical procedure to remove the unwanted bulge. In a similar way, fat in the right places and the right amounts is a sign of youthful vigor. A full face, full breasts (in a female), and full buttocks are all healthy and are considered to be of youthful, if not too full. With aging and changes in weight, these areas can look either too full or too deflated, so taking away tissue (e.g. liposuction) or adding tissue (e.g. fat grafts) can be used to create more desirable proportions, regardless of the part of the body.

Symmetry is also very important to our concept of attractiveness. Most of us are aware that we may have one foot or hand that is bigger than the other, but other areas such as the face, breast, or body can also demonstrate asymmetry. If one side of our face is smaller than the other, we might seek to correct this with fillers to create more balance. Or if one brow is lower than the other, we might try to correct this with Botox® injections or a brow® lift. Breast asymmetry can be particularly concerning to women, and fortunately this can often be addressed when performing a breast cosmetic procedure. If a patient is interested in increasing the size of the breasts with breast augmentation, size asymmetry can be corrected by putting a larger implant on the side that was initially smaller. If a patient wants breast reduction or to reduce her breast size, the larger side can be reduced more. If the asymmetry is in the form of one breast lower than the other, the lower breast can be lifted more. In the same way, if one thigh is bigger than the other, more liposuction can be done on the larger side. At the extremes, very significant differences in breast size, position, or contour can relate to problems with normal development, so correction in these situations can be particularly rewarding to patients.

Gender is a further key aspect of how we assess our appearances. Men want to look and appear as attractive men, and women want to look and appear as attractive women. Gender differences naturally occur in all areas of our bodies. For instance, in the face men naturally have heavier and lower brows, while women naturally have finer, more delicate and higher brows. Women often address the brows by selective plucking to shape and refine, and a brow lift can restore normal brow height. These characteristics, however, also help guide us as surgeons to what we may want to avoid. In a man who wants to lift his brows to reverse the drooping of aging, we need to be careful not to elevate the brows too much as this creates an overly feminized appearance. In men, the development of a feminizing appearance to the breasts is particularly unsettling, and at the same time is quite common, especially with aging. This development – known as gynecomastia – can be successfully treated by liposuction in most cases. Your surgeon must remain aware of gender differences when contouring your body as well. Too straight of a waist in a female tends to look a bit masculine, while to much “curve” looks feminine on a man.

As you can see, aesthetics of the face, breast, and body follow many of the same patterns, and a lot of the same strategies are used from area to area. Let the Emory Aesthetic Center help you think through your particular concerns and develop a plan that is tailored specifically to your desires and needs.

About Dr. Eaves

Felmont Eaves, MDDr. 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.

New Year Refresh: Solutions to Remove Years of Aging

Remove Years of AgingAh . . . the New Year is already upon us, and while we take time to reflect on the year that just flew by, many of us are also looking at our reflection in the mirror. Perhaps that reflection is looking a little tired . . . worn . . . older than the energy you feel inside. Now is a great time to think about what you can do to refresh and rejuvenate that reflection, and get ready for your best year. More than ever before, there are many options to help you achieve this goal.

When you want your face to glow, you can’t ignore great skin care. It is that ongoing skin care that creates a base for everything else you might do for your face. Skin care means really protecting your skin from the sun with the right kind of sun block. It means using the right kind of moisturizers to keep the skin well hydrated. It may mean using targeted cosmeceuticals like retinoids, fruit acids, and other treatments to address fine lines, pigment irregularity, or texture changes. Getting on the right skin care regimen doesn’t have to be complex and it doesn’t have to be difficult – in fact it should only take a few minutes a day – but getting on the right regimen does take expertise. Working together with our licensed aestheticians of the Emory Aesthetic Center Spa, we can help you find the right mix of products tailored for your skin type.

In addition to the base of skin care, there are exciting technologies that you can use to make significant changes in your skin appearance. Lasers, IPL (intense pulsed light), and other energy based devices can tighten skin, fade dark spots, and treat those pesky broken veins. Facial peels can also be used to the same end, but depending on your specific needs, may need to be done in a series – peels are usually milder with minimal down time but may require a building up effect over multiple treatments. Or perhaps you might be a good candidate for a surgical peel or laser that may complete the treatment in a single stage. One newer technology that we’re very excited about is micro-needling, a process that combines tiny needles to stimulate collagen formation and the penetration of growth factors to rejuvenate the skin. Micro-needling takes only a few minutes and you’ll be able to put on makeup and be out the next day.

In addition to great skin care, injectables are highly effective treatments to smooth out wrinkles, grooves, or depressions. These minimally-invasive treatments come in two main forms – those that weaken the muscles that help prevent wrinkles, and those that fill in deeper wrinkles or plump up areas of the face. The “toxins,” such at Botox®, reduce the activity of the muscles of expression. They are used primarily to treat wrinkles of the forehead, between the eyebrows, and the “crow’s feet,” which are the wrinkles from squinting that occur at the corner of the eyes. There are several types of fillers which can be chosen depending on the individual needs and areas to be treated. Typical uses of fillers are to fill out the cheeks, soften the look of bags under the eyes, or to fill in the grooves near the nose and corner of the mouth. While Botox® may take a few days to develop effect, many of the fillers demonstrate an immediate effect. Both types of injections are done during an office visit and you can resume normal activities immediately.

As wonderful as skin care and minimally-invasive treatments are, there are some aesthetic goals that only surgery can produce. Need to get rid of those jowls? Is the skin under the chin loose and saggy? Is the skin of the eyelids loose and droopy, or is the brow low? In these kinds of situations, surgery comes to the rescue. A face lift or neck lift, a brow lift, or a blepharoplasty can provide long-lasting and dramatic results, and the recovery time may be a less than you think.

Depending on your age, skin type, genetics, sun exposure, and other factors, there are many potential treatment options to help you achieve the changes you want. To get the very best results, it is important to come up with a comprehensive game plan that is tailored specifically for you and your individual needs. The game plan may include minimally-invasive treatments like Botox® or fillers, it may include surgery, or it may just require routine skin care and products. The Emory Aesthetic Center can help you pull all these pieces together to create a strategy just for you. Come in for your complimentary consultation.

404-778-6880
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About Dr. Eaves

Felmont Eaves, MDDr. 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.

Related Resources

Holiday Glow – Getting Your Skin Ready for the Holidays

Emory Aesthetic Center Winter GlowYou bought the dress, the new shoes and the jewelry. You secured a babysitter. You have an appointment for your hair. But have you thought about your face? Is your skin ready for the holidays?

The Emory Aesthetic Center Spa can help get your skin ready for the holiday season. The question is how much time do you have before that special event? Let’s discuss the options available to get your skin glowing.

For the Planner – You have everything scheduled weeks in advance.

Since the amount of time required for recovery is not an issue for you, you are a candidate for the most effective non-surgical treatments we have available. This means you will have the most significant change to your skin for your upcoming event.

  • Fractional laser resurfacing can be performed to improve fine lines and wrinkles and the overall texture of your skin. The treatment requires premedication and topical numbing cream. The treatment takes about 45minutes to perform. We ask that you have someone available to drive you home. After the procedure you are very red and swollen and this can last for 3-5days. Your skin will be flaky and rough for up to a week after the treatment. Do this well in advance of a special event. The results can be amazing.
  • Micro-needling is the latest innovation for our Spa, and is similar to fractional laser resurfacing. The difference is that micro-needling is done with small needles as opposed to the laser. It helps with fine lines and improving pore size. Topical numbing cream is used. After the treatment your skin is red, lasting for 1-2 days. The redness however can be easily covered with makeup. Depending on how aggressive your treatment is, some bruising may be evident for up to a week. This is another great option for getting your skin to glow.
  • Medium depth chemical peels are another great way to get your holiday glow. The peel is well tolerated. Minimal discomfort is noted. Immediately after the peel the skin will be red. The peeling process typically begins 3 days after the treatment and can last 4-5 days. Your skin peels in sheets as if you have had sunburn. Beautiful skin is uncovered.
  • Intense pulsed laser (IPL) is another option if you have recovery time. IPL uses laser energy to remove dark spots, irregular pigmentation, and broken blood vessels. It is easily tolerated with minimal discomfort. Your skin will be very red the day of treatment. Brown spots and vessels will appear much darker for up to one week. A great option if spots are an issue.

For the Procrastinator – You tend to do things last minute. You just found a dress and the party is in 2 days, but there is still time to improve your skin.

• A microdermabrasion treatment can be performed to reveal brighter skin. Fine crystals speed exfoliation and the superficial and dull layer of skin is removed. Your skin will be slightly pink after the treatment but will resolve in a few hours. Your new glow is evident the following day.

• We offer a variety of facials that will leave you slightly red after the treatment, although it will resolve in a few hours or the following day. They are a wonderful combination of stress reduction and skin improvement.

• A HydraFacial™ is a multi-step treatment that hydrates the skin and results in glowing skin at the completion of the procedure. No down time required.

No matter how much time you have, the licensed aestheticians at the Emory Aesthetic Center Spa can create an individualized care plan that works for you. We offer all of these treatments and can help you accomplish the goal of glowing skin for the holidays. Take the first step to getting your holiday glow and make an appointment. Visit our website to see our current Specials running through the month of December.

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Facial Peels versus Lasers: Which is Better?

Peels vs. LasersFacial peels and lasers fall under the category of skin resurfacing, which includes treatments that improve skin quality. The improvements range from enhancing the complexion to the elimination of deep wrinkles, and everything in between.

Skin resurfacing is recommended to improve the quality of the skin, skin discoloration, wrinkles and even to some extent to tighten the skin. These treatments are not a substitute for facial surgical procedures or even injectables and dermal fillers, but instead, are regularly recommended as an adjunct to them.

Although the final effect on the skin may be the same for facial peels and lasers, they are very different processes and there is no simple answer as to which one is best.

Both lead to the shedding of the top layer of skin and stimulation of collagen in the deeper skin layers. Facial peels do this through the application of “acid “to the skin, while lasers do it through “heat “energy released by the laser. The acid and the heat result in a “controlled burn” of the upper skin layer. The upper skin layer is then replaced by new or regenerated skin which is smoother in appearance and more even in color. The depth of this “controlled burn “is adjusted according to the condition of the skin and the depth of the wrinkles. The more marked the skin changes, the deeper the treatment and the longer the recovery.

Facial peels are compounded chemicals that are general less costly, and have changed very little if at all over time. There is a variety of peels available ranging from Glycolic acid (fruit acids) to Trichloracetic Acid (TCA) to Phenol and Croton oil peels. The type of peel, the concentration and how it is applied to the skin regulate the degree and depth of the “acid burn”.

Lasers are sophisticated and expensive machines which improve with each new model. There are a variety of lasers such as CO2, Erbium, etc., and the application can be fractioned. The energy level, degree and depth of the laser treatment can be adjusted by turning dials on the laser machine.

Both peels and lasers rely on the experience and knowledge of the practitioner applying the peel or the operator of the laser machine. Lighter peels such as Glycolic acids and lighter TCA peels, as well as some laser treatments may be undertaken in medi-spas and skin spas. However, the deeper and more invasive lasers, and higher concentrations of TCA and Croton oil peels should only be performed by a trained physician in a medical facility.

So which is better? The end results are similar and you should follow the recommendation of your doctor who will choose the modality that will, in their experience, provide you with the best results and the lowest risk. The physicians and aestheticians at the Emory Aesthetic Center are experienced in both modalities and can provide an evaluation and recommendation based on your individual skin needs.

About Dr. Nahai

Foad Nahai, MDFoad Nahai, MD, FACS is internationally recognized as an innovator in the field of plastic surgery where he has developed and refined many procedures. He has co-authored ten books and published over 190 scientific articles on all aspects of plastic surgery. The latest book he authored and edited, published in 2011, is the second edition of his three volume text entitled The Art of Aesthetic Surgery.

He has been invited to lecture and demonstrate plastic surgical procedures all over the world. In addition to numerous professional honors and awards, he is listed in the “Best Doctors in America”, the “Best Doctors in the U.S.”, Town & Country Magazine, Good Housekeeping, More Magazine and Atlanta Magazine as one of the country’s top plastic surgeons. He has been listed in W Magazine as one of the top plastic surgeons in the world. Dr. Nahai is in demand internationally to speak at plastic surgery meetings and to demonstrate surgical procedures.

Dr. Nahai served as the 2008-2010 president of the International Society of Aesthetic Plastic Surgery (ISAPS), he is a past president of the American Society of Aesthetic Plastic Surgery (ASAPS), a former director of the American Board of Plastic Surgery, and is currently Editor-in-Chief of Aesthetic Surgery Journal.

His primary area of expertise is in Face, Neck and Eyelid surgery where he has made significant contributions to the advancement of the art and science of Facial Rejuvenation.

Takeaways from Dr. Nahai’s “Facial Rejuvenation” Live Chat

facial rejuvenationThank you to everyone who joined us for the Facial Rejuvenation live chat hosted by Emory Aesthetic Center surgeon, Dr. Foad Nahai. Dr. Nahai discussed both surgical and nonsurgical solutions to help rejuvenate the face, including dermal fillers, Botox®, eyelid lifts and face lifts.

We were thrilled with the number of people who registered and were able to participate in the chat. The response was so great that we had a few questions we were not able to answer so we will answer them below for your reference. You can also check out the chat transcript for a full list of questions and answers:

Is their a technique such as skin tightening that can decrease hollowness around the eyes and decrease the appearance of dark circles?

Foad Nahai, MDDr. Nahai: Sometimes, shadows resulting from contour irregularities, or hollowness, around the eyes can accentuate the dark circles. Fillers may be a solution in these situations. Also, skin care including retinols, skin bleaches, as well as surgical intervention, such as an eyelid lift, may help to improve this.

Is there a difference in the outcome or a reason to use microdermabrasion versus use of a laser on the face?

Foad Nahai, MDDr. Nahai: There is a very significant difference between the two. Microdermabrasion is a lighter therapy and is used for more superficial purposes. Laser resurfacing, however, can range from light and superficial, to heavy and deep. Both are effective for minor skin changes but only lasers can be used for more significant or deeper problems.

How can I get rid of under the eye wrinkles and is there something that can be done to whiten eye sclera?

Foad Nahai, MDDr. Nahai: There are several options for improving eye wrinkles that include creams, facial peels and surgical skin removal or lifting. After examining your skin, a specialist will be able to recommend the best treatment for you. There are eye drops available which can help to improve “blood shot” eyes, but there is not a procedure to whiten the sclera.

I fell a couple years ago, and my forehead hit a curb right above my eye. Of course I had a huge black eye as a result. It has been 2 years and I still have darkness around that eye – a shadow in the same shape as the black eye. Can anything be done to lighten this?

Foad Nahai, MDDr. Nahai: Dark circles under the eyes represent one of the most challenging areas for improvement. The eyelid skin is extremely thin, with minimal if any fat between the skin and muscle. However, there are non- surgical options, such as retinols and skin bleaches, and surgical options that can help provide some improvement.

Question: Is there anything you recommend for the treatment of rosacea?

Foad Nahai, MDDr. Nahai: A variety of topical agents are available to treat rosacea. After an evaluation of your condition by a dermatologist, he/she should be able to advise you on the best treatment options for you.

 

If you missed this informative chat with Dr. Nahai, be sure to check out the full list of questions and answers on the chat transcript. Be sure to visit the Emory Aesthetic Center website for more information on therapies and solutions to keep you looking your best.