Microneedling has now come of age and is considered as its own unique and specific skincare treatment category.  In this exclusive interview with Aesthetic Insider Radio, Dr. Asher Milgrom of AMA Skincare, discusses how they incorporate the advanced Innopen from Clinical Resolution Laboratory, Inc .into their aesthetic treatment protocols for wrinkles, scars, cellulite and Pigment correction. To learn more about AMA Skincare, visit www.amaskincare.com. To learn more about Clinical Resolution Laboratories, visit www.skincarecrl.com

Tell us how AMA Skincare began?
Dr. Pien, who is also my wife, has a background in emergency-medicine and pediatric trauma and I come from a MD, PhD program that specialized in medical sciences. Eventually, we became interested in integrated medicine which later evolved into developing a practice that had an expertise in aesthetic and regenerative procedures. Since we opened AMA Skincare over twenty years ago, we have completed over eighty-five thousand diverse procedures in our office.

How frequently do you use microneedling in your practice?
We work with over twenty-five unique lasers and as our practice has developed, microneedling came to our attention and we use it quite frequently for the numerous procedures we perform. Microneedling is an extremely effective tool that we have at our disposal, and as a practice that specializes in developing integrated procedures, we are married to the results not to the technology. We continuously participate in various research projects and investigation and review boards for the FDA as new technologies emerge.

How is microneedling an effective aesthetic treatment?
Microneedling is quite efficient for stimulating the collagen. We induce micro columns of damage into the dermis and the needling stimulates and turns on the regeneration of the collagen. It is also an effective treatment for acne and surgical scars that are keloid because it powerfully stimulates and remodels the scar tissue. Additionally, microneedling can be used to infuse serums, stem cells, growth factors, and physiological regulating medicine into the tissue. We have several patients that seek our help after surgeries because they have concerns regarding the unsightly appearance of surgical scars and microneedling is an effective modality that we use for remodeling those scars, and is often much less expensive than laser treatments.

Tell us a patient story where Clinical Resolution Laboratory and  the InnoPen has been significant in treating the patient.
We recently treated a young lady who was bitten in the face by a dog. She got a little too close to the dog’s personal space. Consequently, the dog bite did not produce a clean cut, which is expected, thus the scars result was quite obvious and microneedling was a tremendous treatment in that case.

Does microneedling technology help cellulite?
Cellulite is tough because it is the issue of excess fat coupled with how the subcutaneous fat layer in women is fractured. We have been exploring the best technologies for years and have not used microneedling a lot in that exploration as of yet.

Do you think microneedling would be helpful with stretch marks?
Absolutely. We have been working on a research project for over a year that is addressing stretch marks from all different sources including: pregnancy, obesity, and muscle building. In our research project, we have been utilizing stem cell research on stretch marks and microneedling has become a critical part of that because we need to infuse the stem cells into the stretch mark at various points in order to generate new skin, which reforms and remodels the stretch marks.

What role does microneedling play regarding skin rejuvenation for patients?
We specialize in combining several modalities to stimulate natural physiological course and to rebuild a young, healthy, new, and beautiful complexion. Since we have a multitude of lasers, we use them in tandem with microneedling. Many patients want the microneedling over the entire face sometimes for an easy, quick, and extensive stimulation of tightening and rejuvenation, and that closes all the pores.

Is microneedling a technology that is easily accessible for practitioners to learn that want to incorporate it into their practice?
The practitioner would need the necessary coordination that is required to be applying this technology to a patient’s face. Typically, it takes about ten trials to learn the proper depths of the needle and different parts of the face. Also, the practitioner will have to be knowledgeable in the different types of skin on the face in order to use the correct depth of penetration and learn the expected and potential response of the skin as they are microneedling.

Tell us the benefits of the microneedling pen used with a closed tip stamping motion and can the patient feel the difference?
Patients can definitely feel the difference. The first microneedling devices were rollers, similar to a paint roller but with tiny needles and it would roll over someone’s skin and tear on the way in and on the way out, which was quite painful. Additionally, the damage caused by the tearing was unnecessary. It is important to create a balance between stimulating the collagen regeneration and stimulating scar tissue generation. Contrastingly, the InnoPen needles are on a rotating motor, they move quickly and move up and down perpendicular to the pen. It is similar to an acupuncture needle that is inserted directly into the skin in an up and down motion. The damage that is created is in the insertion to the skin, which is extremely precise and measured in its effect. It stimulates the kind of regeneration of collagen that will close the pores and tighten the upper layers of dermis and the papillary dermis. For ultimate patient comfort, a practitioner has to learn how to precisely utilize it around the face.

Is microneedling an effective choice for all skin types?
In regards to the stimulation of generating collagen it is effective for all skin types; however, there are certain skin types that are prone to post-inflammatory hyperpigmentation, which typically are Asian Hispanic, and Pakistani skin types. We proceed cautiously on patients if we are unsure of how their skin will react regarding hyperpigmentation. In this case, we test a small patch of skin and wait roughly three days to see if microneedling will be the right treatment for the patient and take precautions to avoid hyperpigmentation. Also, it is critical that a practitioner does not perform any microneedling on skin with an infection or active cystic acne.
 
What are some safety aspects to consider with microneedling?
Practitioners need to fully understand how to set the pen for the correct depth given the thickness of skin, which changes based on which area of the face you are utilizing the microneedle. Additionally, if you use supplements or different formulations that you are infusing, you need to be certain that you are using the correct formulations.

What motivated you to choose Clinical Resolution’s InnoPen over the other designs available on the market?
We have tried them all. When new technologies emerge, manufacturers seek us out and ask if we will evaluate them, and we are involved in the investigational review board, IRV for the FDA, which gives us the opportunity to try several technologies and we report back to the FDA on the efficacy, safety, and reliability of the technology. It is a deliberate choice that we use InnoPen in our practice because it is an extremely reliable technology.

What would you recommend to the practitioner searching for the right device for their practice?
It is all about individual customization for each patient. It is important to assess the patient’s unique physiological landscape and match that assessment with the proper protocol, using the correct modalities, and tools. Microneedling is an effective tool, but I encourage competition amongst different devices and manufacturers, whichever tool is going to be most beneficial to the patient. You need to be clear in what your goals are for the patient, know what will be best for their physiological makeup and apply the right technology accordingly.

To learn more about AMA Skincare, visit www.amaskincare.com

To learn more about Clinical Resolution Lab, Inc. visit www.skincareCRL.com

To listen to Dr. Asher Milgrom’s full interview at Aesthetic Insider Radio,CLICK HERE!

The post How Advanced Microneedling Technology Can Deliver Excellent Patient Results appeared first on Aesthetic Insider.

As new technologies and procedures become increasingly available so has the demand for more non-surgical and also surgical procedures. Learning how to efficiently manage  interest from prospective and current patients is a difficult challenge for many aesthetic practices.  In this interview, Shana Greenlee, Director of Marketing at The Centre, P.C. in Mishawaka, Indiana discusses with Aesthetic Insider Radio the best practices for patient scheduling, outstanding lead management and the importance of delivering the ultimate VIP patient experience for the utmost practice success.  Shana Greenlee explains how Red Spot Interactive manages their ROI, new patient leads, and schedules new patient appointments and how that has been critical to their overall success. To learn more about Red Spot Interactive, visit www.redspotinteractive.com. To learn more about The Centre, P.C., visit www.thecentrepc.com/plastic-surgery

Shana Greenlee

Tell us about yourself and The Centre, P.C.
I’m the Director of Marketing and the Director of Cosmetic Surgery at The Centre P.C.  and we have been in practice for over twenty six years with Dr. Ronald Downs and Dr. Patrick Viscardi as our lead physicians. The Center P.C. offers cosmetic and reconstructive surgery as well as a medical spa, wellness center and therapy center.

How does the practice ensure the overall effectiveness of its patient scheduling process?
With the help of Red Spot Interactive we have a very effective scheduling process and consequently we are able to deliver a VIP treatment to each patient. Since our practice is tremendously popular, Red Spot Interactive has been critical in our success of delivering that VIP treatment through their call answering service, which is able to answer the numerous questions newer patients have when considering a cosmetic procedure that we simply do not have the time to answer on our own and still deliver that VIP experience.  Red Spot Interactive schedules appointments for us which has been immensely helpful since we have such a large call volume. They have created a wonderful system and they track everything which allows me as the Marketing Director to see which campaigns are working or not.

Does Red Spot Interactive allow you to monitor lead conversion rates?
Absolutely, measuring the conversion rate is especially important to me. If I’m spending a significant amount of money in marketing and I am managing our Facebook Live and other videos, I want to see that it is converting to patient consultations.  Red Spot Interactive allows us to monitor conversion rates with the use of a dashboard. In the dashboard, we are able to see the whole process from the initial phone call the patient made, to the new patient consultation, all the way through to when they complete a procedure, and how much they spent.  What I especially like is that I can continue to see new and existing patient activity, and see which of our marketing efforts converted each patient.

What are some of the most important conversion metrics that you monitor?
Patients primarily contact us via an email or phone call, making those two mediums vitally important to monitor.  Also, it is important for me to oversee our marketing leads, attendance and scheduling rates, and how quickly prospective patients convert into new patients.

How do you handle patients that want to see a doctor, but are not able to schedule a consultation for quite some time due to the doctors’ schedules being booked so far in advance?
Red Spot Interactive is excellent at evaluating the situation of each patient and quickly determines if the call should move forward to the office if there is a pressing need or medical emergency. They will actually transfer that call to the office and let the office staff address the situation to see if there is anything they can do last minute.

How do you keep missed appointments to a minimum?
All patients like to be reminded about their appointment. Red Spot Interactive sends reminders from our practice through emails, texts, and phone calls.  From there, we will go into our system and see if the patient confirms the appointment and if not, my own staff will call or text the patient, reminding them the day before. Unfortunately, no shows are going to happen no matter what, however, Red Spot Interactive has helped our practice keep those rates down by sending out reminders.

How do you prioritize appointments for your aesthetic practice?
Red Spot Interactive is able to prioritize appointments by evaluating each appointment type and the provider. When I initially tried Red Spot Interactive we sat down and went over how each provider likes to prioritize appointments. We do our best to prioritize surgical procedures over non-surgical. It’s all about communication with the providers. We always want to prioritize surgical patients over injectable patients because that is where the doctor wants to spend their time and where profits are maximized.

How do you track the source of your leads?
It’s crucial for me that I know where new patients are coming from and which one of our marketing channels led them to us. Red Spot Interactive tracks and records all the different ways patients come to us from our radio ads to Google ads by directly asking every single patient how they heard about The Center P.C. It is incredibly insightful information for me because it allows me to look at my budget and see ROI. For example if our marketing with Google ad words brought in several new patients, I am going to continue to prioritize my budget in that department. On the opposite end, if we spent a significant amount of money on print ads and did not see a great return on investment from those ads, I am not going to put more money into print marketing. Marketing is expensive and I don’t want to spend money on something that gives us zero patients in return.

What are some of the key factors to successful lead management and patient scheduling?
Giving patients the VIP treatment and experience by delivering excellent customer service fosters good relationships with patient and has a positive outcome when they review the practice. Red Spot Interactive records all our phone calls which is critical because it allows us pull a call and get to the facts if there is a problem. It also gives us one more way to avoid miscommunication and make sure patients are happy. Red Spot Interactive does an excellent job with lead management and as a result our practice has skyrocketed. Our ROI has definitely seen a huge turnover and increased since we started working with them. Red Spot Interactive additionally does drip marketing which I personally love as it is a great way of engaging a patient. For instance, a patient comes in and they have a consultation, then the drip marketing campaign begins. It’s a fantastic tool that Red Spot Interactive has given us; they definitely know what they are doing there. What I saw in our practice is that we needed a solution and they were our solution.  Without them we wouldn’t be as successful as we are.

To learn more about The Center P.C., visit www.thecentrepc.com

To learn more about Red Spot Interactive., visit www.redspotinteractive.com

To listen to Shana GreenLee’s full interview at Aesthetic Insider Radio CLICK HERE!

The post Lead Management and Patient Scheduling Best Practices appeared first on Aesthetic Insider.

Dr. Dennis Schimpf

Plastic surgery is hyper-competitive both academically and in business.  After an aesthetic practice has devoted significant time, money and energy into acquiring new patients, it is then crucial to the success of every practice to maintain and retain each patient relationship. Correctly managed patient relationships will seamlessly encourage recurring future appointments for necessary maintenance and/or other new procedures and treatments. In this fascinating interview with Aesthetic Insider, Dr. Dennis Schimpf of Sweetgrass Plastic Surgery discusses how Red Spot Interactive, a marketing and patient acquisition company, has combined classic marketing techniques with technology that allows a practice to correctly understand the true value of each patient, develop lasting relationships with them and ultimately retain and acquire more patients for total practice success. To learn more about Dr. Schimpf, visit www.sweetgrassplasticsurgery.com. To learn more about Red Spot Interactive, visit www.redspotinteractive.com.

What prompted you to go into plastic surgery?
I came to plastic surgery through a non-traditional route. Initially, I was a philosophy major, and my senior year of undergraduate, I volunteered in an emergency room and fell in love with medicine. Subsequently, I decided to go into a full general surgery residency followed by a plastic surgery fellowship at the Medical University of South Carolina in Charleston. Following my completion at University, I obtained a faculty position there and spent five years doing primarily breast reconstruction. Afterwards, I shifted to private practice and during that time, I acquired my MBA in International Business at the Darla Moore School of Business from the University of South Carolina.

What is patient lifetime value?
Patient lifetime value is the prediction of the overall worth of a patient to a practice over the total time span of that relationship between the practice and the patient. That value is not only based on their personal procedures, but in the referrals they will bring to the practice.

Why is it important to know the patients lifetime value?
To build a prosperous practice, it is critical to know the value of current patients and the value over the course of their lifetime. Additionally, when you have steady patient retention, which comes from how a patient feels when they come to the practice, it is easier to convert them to new procedures we may be currently offering or additional ones they may need in the future. For example, a thirty year old female patient may come in for fillers, she may later have children and want abdominoplasty, and later in her fifties begin face procedures. The return on investment is especially important to consider when you look at that patient retention and value. Also, when thinking about ROI, it is crucial to consider the cost of patient acquisition. An abundance of money goes into marketing and advertising to attain new patients. A patient will see a print advertisement or billboard numerous times before they are inspired to begin a particular procedure, which is indirect ROI. However, with direct ROI you can see exactly the number of people that saw the advertisement, clicked on the call to action, and actually completed the procedure.

How does Red Spot Interactive track ROI for you?
They generate a report that outlines what we spent on a campaign, the number of conversions, and patients that completed procedures. Additionally, they track the overall lifetime of a patient and inform us of the number of patients that come to our practice and had a procedure, both established and new patients. This allows us to examine which marketing tactics have been most effective for us. It also provides us the ability to determine where we should be investing in marketing. We primarily choose where we are going to invest in our marketing based on our ROI, which Red Spot Interactive calculates, and the other half of what we are going to spend in our marketing comes from how we want to build our brand.

How do you calculate your practice’s patient lifetime value?
Our Red Spot Interactive platform calculates and tracks the number of times that a patient has come into the practice and the money they have spent which determines the patient’s lifetime value. They are in charge of our lead management, making appointments, seeing how many of the patients actually show up to the appointment and make a purchase. CEO of Red Spot Interactive, Jason Tuchman regularly engages with businesses and advises us on which marketing campaigns and advertising efforts are producing conversions for us and which are not.

What can a practice do to improve the lifetime value of a patient?
A practice needs to truly know their audience and develop a marketing plan accordingly. It starts with the advertising and understanding how it makes the prospective patient feel when they look at it. Within your marketing, it is critical that you make an emotional connection with your potential patient and current patients in order to build trust. You need to understand what is going to help your patients, whether it is introducing a new product or technology, you need to know your patient base and realize just where your patients are showing more interest. When you truly support them and their needs, they will continue to come back to your practice on a regular basis. A practice needs to instill confidence in the patient in what it is doing for them and that they can depend on it. We want our patients to know that we appreciate them and their happiness is a priority for us, and that helps us create loyalty among our patients. Creating this patient loyalty is part of the value that, over their lifetime, they want to keep coming back to you and enjoying that value you bring to them. Also, we are firm believers that establishing patient loyalty starts with our practice employees. When hiring, we look for individuals who interact well with the public, are customer service oriented, can make our patients feel appreciated, and who understand that patient satisfaction is our number one priority.

What are the most important steps a practice can take to set itself apart in terms of patient/customer service?
Establishing a follow up method that makes the patient feel safe and cared for after the procedure is critical. For example, we give our patients direct contact after surgery. We will give the patient the surgeon’s cellphone number which makes them feel good, gives them peace of mind, and builds trust.  Building that trust is essential for building lifetime value. Also making sure each patient is knowledgeable about all the different procedures you offer. It is this combination of developing that trust so that they keep coming back and educating them on everything you have to offer that sets a practice apart. Even if the patient doesn’t need a particular procedure right now, they might want to in the future and your practice is the one they are going to call because you have built that loyalty.

Do you think that it’s true that the existing patients and referrals are the top three revenue drivers within the practice?
Yes, 100%. Existing patients are the first priority in that list. When a patient actually completes a procedure, and they refer a new patient to you, they become a trustworthy and reliable source because they have experienced it for themselves. Once you have a patient in the system, and they are a part of your contact list, creating an email blast on a new procedure or discount is extremely cost efficient because you can reach thousands of people in an inexpensive message that converts into revenue. Marketing and acquiring a new patient is considerably more costly than keeping a patient. Thousands of dollars go into marketing and we currently spend 10% of gross revenue monthly on marketing which includes everything from radio, billboards, print, internet, pay per click, and SEO. Advertising is expensive, but a necessity of business growth.

Is there a system with a dashboard with Red Spot Interactive that allows you to figure out the ROI and understand your patient value?
Yes, we have access to a dashboard which is continuously updated with the most current information. Also, whenever we have a question on our progress with a particular marketing campaign or our conversions, they have been a tremendous support in getting that information to us. Red Spot Interactive works with roughly one hundred seventy practices which is of great benefit to us because not only do they evaluate my practice, but they are able to bring their knowledge and expertise from all those other practices. They truly guide us in making the best marketing decisions based on what has been working for practices or what they have tried in other practices and it hasn’t been successful. This knowledge allows us to utilize our marketing spending for the best return on investment.

How has having the patient lifetime value knowledge and knowing the dollar amount associated with patients influenced your marketing decisions?
Once you know the dollar amount associated with a patient you already have, the patient lifetime value is clear. It is vastly more economical to cultivate the current patient with direct marketing through advertisements and information in the office, patient events, and open houses than spending our marketing dollars on acquiring new patients. We work on building a relationship of trust with our patients so they feel like family and when you have that connection, that’s when patient lifetime value truly increases. It is a necessity for business growth to have that lifetime value and to be certain that it’s increasing.

To learn more about Dr. Schimpf, visit www.sweetgrassplasticsurgery.com.

 To learn more about Red Spot Interactive, visit www.redspotinteractive.com.

To listen to Dr. Schimpf’s full interview at Aesthetic Insider Radio CLICK HERE!

The post Patient Lifetime Value The Key to Success in a Plastic Surgery Practice appeared first on Aesthetic Insider.

Most aesthetic patients do not manage pain easily and with an ever increasing variety of procedures and devices available that can cause discomfort or pain during treatment, delivering comfort to the patient has become even more critical. In this interview with Aesthetic Insider Dr. Cynthia Poulos, a plastic surgeon in Northborough, MA, discusses how she successfully manages patient pain during aesthetic treatments. Dr. Poulos has over 35 years of clinical experience and uses Numb Master from Clinical Resolution Laboratory, a one-of-a-kind breakthrough technology that allows for the most effective penetration of a topical anesthetic, to provide a higher level and more soothing experience for her patients. To learn more about Dr. Poulos, visit www.drpoulos.com.  To learn more about Numb Master from Clinical Resolution Lab., Inc., visit www.SkinCareCRL.com

Which aesthetic procedures do you find benefit the most from a numbing cream?
Nearly every patient that comes in for fillers or Botox is treated with Numb Master. We like to ease any potential discomfort a patient may experience in treatments in which multiple needles are needed.  Any procedure that is going to involve full face treatment is pre-treated with Numb Master thirty to forty-five minutes ahead of the procedure depending on how aggressive we want to be with the treatment or the patient’s tolerance to those treatments.

Why did you specifically choose Numb Master?
We tried numerous products over the years, and after exploring several products we found Numb Master. We love that it is a single use product and is formulated from lidocaine which means we can control the application and know if a patient is sensitive to lidocaine or not. Another wonderful benefit to the product is it’s a cream based formula, not an oily based formula, which makes the application and removal of the product ultimately easier. Additionally, the penetration of Numb Master is excellent and my staff and I agree it is an effective and profound topical.

Do you have particular protocols for use of this product?
The protocols for Numb Master truly depend on the procedure. For example, for a Botox treatment, ten minutes is sufficient for a single area. Maximum effect typically takes place around twenty minutes, but with most of our patients we find that ten minutes is enough time to numb when we are not doing extensive work. In regards to more invasive treatments, it could take a half hour to forty-five minutes in numbing time. Patient comfort is incredibly important to us. When a patient is prepared more comfortably for a procedure, they breathe easier, they relax, their blood pressure and pulse is lower, and they typically bruise less because they are more comfortable. The cream itself is not making them bruise less, but all the benefits of their comfort level are.

Does Clinical Resolution Laboratory’s Numb Master work differently on skin types?
For my practice, it has been equally effective on thicker and thinner skin; it is universally used with efficacy across various skin types.

Does Numb Master have less toxicity because it is primarily formulated from lidocaine versus many topical numbing creams which are made with BLT (Benzocaine, Lidocaine and Tetracaine ).
The lidocaine percentage is higher, but because of its formulation, the penetration is as effective as a BLT formulation. I’m all for creating simplicity and if a patient is experiencing sensitivity then we know it is related to that one product, versus having to discern between the triple creams and dissect which product is responsible for the sensitivity because the product I’m using has one active ingredient. This product gives me more control over the process in both the application and potential patient sensitivity, and I have yet to find a patient who is sensitive to it.

Lidocaine is delivered by technology, can you explain that process?
It allows penetration through the skin layers. You want this product to penetrate as much as it can, because the more penetrations to the dermal level, the greater comfort the patient will have. The liposomal aspect of it is what allows the active ingredient to penetrate in depth through the skin surface to the dermal level which is where you want more active numbing. It has to pass through the tough surface of the skin where there is keratin which can be resistant to penetration from a product. Numb Master is truly a unique product because you get more effective penetration of the product and thus a more profound numbing.

Have you ever had any kind of patient experiences where the Numb Master had played a more significant part in helping you manage a challenging case more than you had expected?
With resurfacing types of procedures, we see more significant clinical outcome. When doing a treatment that involves a full face micro-needling with radio frequency and treating the neck and face with multiple passes, we need a reliable product that is effective and functions well for a procedure that may take an hour. It’s the heat that’s delivered that creates that collagen response, the skin tightening, the effacement of wrinkles, lines, and textural improvement. Thus, if we can do a more aggressive treatment because the patient is more comfortable, we are ultimately going to get the desired result.

Is there anything that you do in advance of a treatment such as a laser treatment or any treatment to increase the potential numbing effect of the product?
We pretreat our patients with topical retinoids and vitamin C. Those products help prepare the skin because we are decreasing some of the keratin that’s on the skin surface and are creating exfoliation. Anything that’s allows for pretreatment exfoliation is going to aid in penetration. When you remove all those old dead cells in the pretreatment phase, you’re going to achieve a more effective penetration of product and thus a more effective treatment. We try to pretreat most of our patients to their tolerance with retinoids and vitamin C and several other products to remove thekeratin layer which helps the penetration of the product.

In your practice, do you apply anything over the cream to minimize the evaporation and drying of the product?
We do not within my practice and I know that some practices do. When you are treating body areas, you must be careful with how much of the product you are applying, you don’t want to give too high of a dosage.  In our experience, the topical alone works.  We found that the longer you keep it on there’s a little bit of a drying effect, but it almost forms a seal. To remove the product when it’s been on longer we use warm moist towels to rehydrate the product prior to the full removal of the product.

Numb Master is made here in the USA and we have extremely high FDA quality guidelines. However, some products do come from overseas, are you concerned about not knowing quite what’s in them?
Well, you want to know that you are getting a quality product. We don’t always know what’s in the products from overseas and you could get an okay product, but how would you know? There is definitely an element of reassurance in quality when the products are made in the USA. You don’t want to get something just because it’s cheaper and you can get it outside of this country. I think we owe it to our patients to use what we know is properly manufactured; that’s extremely important to us and I’m very happy that Numb Master is made in the USA.

How important is patient care and comfort?
Frequently we will examine what we can do to make our presentation and delivery of care better for our patients. We are less concerned with the quantity of appointments we have scheduled in a day and are more concerned with providing exceptional value.  It is our top mission to provide the utmost care and quality with each patient that comes through our doors.

To learn more about Dr. Cynthia Poulos visit www.drpoulos.com

To learn more about Clinical Resolution Laboratory and the Numb Master product, listeners can go to www.SkinCareCRL.com.

To listen to Dr. Poulos’s full interview at Aesthetic Insider Radio, CLICK HERE!

The post How Using A Topical Numbing Agent Can Help Manage Patient Pain During An Aesthetic Procedure appeared first on Aesthetic Insider.

The aesthetic medical profession is currently experiencing an exciting moment in history where the scientific possibilities available to plastic, facial plastic and cosmetic surgeons are rapidly increasing with new techniques and technologies that improve or even change established surgical protocols and safely deliver superior patient results. In this ground breaking interview with Aesthetic Insider, Gregory Mueller, MD, a board certified plastic surgeon located in Beverly Hills, CA, discusses Ellevate a new and exciting minimally invasive lower face jawline and neck rejuvenation procedure he has pioneered. The Ellevate procedure is a completely new approach to address the underlying muscles and glands of the neck. To date no other minimally invasive technology exists that will treat the underlying neck structures percutaneously. The Ellevate procedure is a great adjunct to all technologies and approaches that either tighten the skin or remove/dissolve fat. Many of these approaches leave visible neck bands and droopy glands. Ellevate is the first and only procedure that allows the oversewing of these structures to support and shape the neck contours underneath the skin. Dr. Mueller invented the ICLED® light guided surgical system that is used to perform the Ellevate procedure. The ICLED® is also used in many applications such as brow lifts, brow shaping, facelifts, and breast reconstruction. To learn more, visit www.myellevate.com.

Gregory Mueller, MD, Beverly Hills, CA

Dr. Mueller, as well as being a practicing plastic surgeon, how did you also become a pioneer in new aesthetic technologies?
I have been in practice since 1998 and over the last 20 years my practice has evolved into the inclusion of less invasive technologies because that’s what patients are demanding. At my practice in Beverly Hills, I perform facelift surgery, tummy tucks and body contouring, as well as radiofrequency skin tightening, laser treatments for sun damage and other similar procedures. My first invention was in 2006 when I developed the concept of light guided suture placement, which is now known as the ICLED® light guided surgical system. The ICLED® light guided surgical system received FDA clearance in 2009 and is an illuminated suture rod that allows the surgeon to deliver sutures underneath the skin to elevate and approximate soft tissue. We now use this system for brow lifts, facial and neck contouring, and breast contouring.  It’s a great way to less invasively shape, contour and elevate soft tissue in cosmetic surgery. Over the years, using that light guided surgical system, I realized a great use of it which is a minimally invasive facial procedure I’ve named the Ellevate procedure which is a way to support the glands at the back part of the neck to refine the neck area and jawline. In 2011 I invented the oVio360 Dynamic Imaging System, which is a robotic dynamic image capture system that captures standardized before-and-after images in a 360 degree format in perfectly the same lighting. The oVio360 allows doctors and patient a complete and accurate 360 degree video capture that they review during consultations, and post-surgery to carefully evaluate results. So, both of these are my big innovations, but I have to say the one I’m most excited about is Ellevate.

What is Ellevate and how does it work?
Ellevate is a procedure that addresses the glands and the muscles underneath the skin of the neck which has often been a neglected area by both patients and surgeons until more recent years with the introduction of sub-mental liposuction, injectables and Kybella. I had been treating this area surgically but since developing the ICLED®, developing a non-invasive permanent procedure became important to me. Ellevate enhances the neck and highlights the back part of the jaw line which is a very strong sign of beauty. Using the ICLED®  surgical suture system which consists of an illuminated suture rod and suture system that is mapped out and placed underneath the skin to support and refine the neck and jawline area, patients can now see a much more defined and youthful lower face and jawline which is exciting. Ellevate is also a very complimentary procedure and for patients that require a little more enhancement, can be used in conjunction with other technologies such as radiofrequency laser, ultrasound and, as mentioned previously, sub-mental liposuction and Kybella®.

Is the Ellevate procedure specifically for lower face, jawline and neck revitalization or is it considered a facelift?
Ellevate is very different to a facelift. It’s not a facelift or a neck lift and is something totally new. Ellevate does not require incisions or removal of skin, can be performed under local anesthesia in about one hour in the office, and requires little anesthesia and almost zero downtime. That’s what is so remarkable about this technique. Ellevate is a method to support the foundation of the neck that the skin lies upon to really sculpt and refine the neck.

Does Ellevate require special training?
Yes. Ellevate is best suited to surgeons that are already familiar with aesthetic improvement of the face and neck and training programs are offered to board certified plastic surgeons, facial plastic surgeons and cosmetic surgeons that specialize in facial aesthetics.

How is the Ellevate technique different to a thread lift procedure?
Ellevate is quite different to a thread lift for several reasons, the most important one being the long lasting ability of Ellevate. The suture material we use to create the support sling underneath the jawline is a permanent braided polyester suture, and where it is placed also differs from the thread lift (PDO threads or absorbable threads) in that we place the thread a little bit deeper and we place it right over the muscle and beneath the skin using the ICLED® lighted Suture Rod. This is what allows us to travel in the exact location, so that we’re not too close to the surface or too deep, to actually permanently support the glands and muscles of the neck. With the ICLED® light guidance it makes Ellevate much more accurate and with the permanent suture material, it is also much more long lasting.  Also, the structure of the Ellevate suture is much different to PDO threads or absorbable threads which are single strands sutures that are placed to sort of elevate skin. The Ellevate suture is actually a continuous loop that goes underneath the entire area of the jawline and really supports it over the long term. It is also non-absorbable, thereby making it more permanent.

How long do the results of the Ellevate procedure last?
I began developing and performing Ellevate in 2011 and now have patients that are seven plus years out and with strong results, so far I consider the results to be very long lasting with a five to seven year plus success rate.

How does that compare with durability of Thread Lifts?
Time will tell and Ellevate may even last little bit longer, but just like when I’m doing a facelift or a neck lift we always tell patients we are essentially going to reset the aging clock and then it’s going to start marching forward.  I feel the same thing is true with Ellevate. The nice thing is it really supports the glands and also supports and smooths the muscles, so the patients obtains an immediate new refined neck and it’s long lasting. At best Thread Lifts can lift tissue for a short period of time before they are absorbed.  Absorbable sutures are not long lasting enough to hold the glands and muscles in a new position in the way that Ellevate can.

Who is the ideal candidate for the Ellevate procedure?
The ideal candidate for this procedure is a patient who is hesitant about going under the knife in the traditional invasive sense, with minimal skin laxity and who is just starting to show early signs of aging. If you look at someone’s profile and see that their neck line is looking like a ski slope, rather than a nice right angle underneath the chin, those are the most ideal patients.  Also, patients who have glands that are prominent underneath the neck line, which happens to a lot of people genetically and are not even age related, those are patients that also experience a great result with Ellevate. The list goes on, as even a patient who is thinking about having a skin tightening procedure may also need Ellevate as the technology may tighten the skin, but it does not do anything to address the underlying muscles and glands which are causing the neck to look aged. Ellevate is the only procedure that is percutaneous and addresses these problem areas.

Does Ellevate improve the jawline?
Yes. The two strands of the Ellevate system extend from behind each ear all the way underneath the chin, and underneath the back of the jawline to support and shape the neck as well as suspending the glands. This provides an accurate shaping of the neck and jawline. Most patients say they feel as though this is the first time in their life that they actually see that they have a defined jawline.

Is it possible for Ellevate to improve the back of the jawline and give it definition in the same way you see many model faces in beauty magazines?
What many people are unaware of is that when they have their skin tightened, or have a little fat removed or undergo a Kybella® treatment, the glands and muscles in the neck have nothing to support them and they are actually heavier than the skin. So, they might have a little less heaviness or improved tissue but the neck and jawline is still not defined due to the weight of the glands and muscles. The way Ellevate works is it accurately passes right over those areas and when we evaluate each patient we mark those areas where they have the least desirable neck contours and place Ellevate in those areas to support and shape that part of the neck line. The same considerations are used when we use Ellevate to define the back part of the jawline. Not everyone can have a model face, but with Ellevate they can definitely have a more defined back jawline which carries with it the look of youth and beauty.

How long does Ellevate take to perform and what is the downtime?
What makes Ellevate so exciting is that it is an in-office procedure that only takes about one hour to perform which patients really appreciate as it is a procedure that gives instant and permanent results that they can have performed on a Thursday or Friday and literally be back at work by Monday.  The patients go home wearing a chin strap and when they return the next day for their post-operative check-up they are just amazed to see their results. Most of them have very little bruising or swelling and could actually go to work the next day with minimal signs of a procedure. We do, of course, recommend no heavy lifting or heavy workouts at the gym which is normal with most procedures. Also, there are no stiches or incisions so there is very little in the way of post-procedural care. Patients can shower the next day, although as mentioned previously, we do tell them not to work out at the gym for a couple of weeks, because people who work out too soon will get more swelling.

What is required for a surgeon to be able to perform the Ellevate procedure?
We only train doctors who are experienced in surgery of the head and neck, preferably a plastic surgeon, facial plastic surgeon or other surgeons who are trained in this type of surgery. If a surgeon knows how to do liposuction of the neck, then they would also be qualified to perform Ellevate. We have an instructional video that I made for this technique in addition to many of the techniques that we do with the ICLED® system, but Ellevate is the one I’m most excited about. Those doctors that choose to train in the Ellevate procedure will watch an instructional video which demonstrates the marking and the sequencing of the skin and how we pass the ICLED® Lighted Suture Rod underneath the skin to accurate place Ellevate. Then the doctor will come and observe either myself or another doctor in their area who is trained in the Ellevate procedure and view the procedure live.  This is important as the surgeon can watch the procedure live and ask questions. The third step is for the surgeon to go ahead and perform a procedure. Most surgeons trained in facial anatomy and liposuction find Ellevate to be a procedure they become comfortable with very quickly especially as the ICLED® light guidance makes it easier for them to see where they are placing the Ellevate double strand loop underneath the jawline.

Is the ICLED®device integral to this procedure and is additional training required?
Yes, it is essential. The ICLED® suture system kit consists of a puncture device that makes precise punctures in the skin, followed by what we call the dermal clearing device that is inserted into each puncture to clear the dermal attachments around each puncture.  The light handle and the Suture Rod are used to construct the suture matrix underneath the skin using the LED light guidance.  The suture rod is illuminated as its tip, so that light transilluminates through the skin. Everything comes in the kit that the doctor will need, and during the Ellevate demonstration we show how the kit works.  The nice thing is that the suture rod is not sharp, it’s blunt and the surgeon just attaches the light to one end and inserts the other end underneath the skin allowing them to watch the light as it passes under the tissue.  The user will want to keep the trans-illumination light a soft yellow hue which indicates they are not too deep and that they are in the fatty layer which sits right underneath the skin and over the muscle. This allows the user to pass the ICLED® suture rod and attached suture from one pivot point to the next, creating a suture suspension system over the underlying muscles and glands.

Does Ellevate require general anesthesia?
When I meet with my patients I always assess and ask them would they be more comfortable with local anesthesia and there are few who say oh, no I’d rather be asleep.  So, for those patients we would use general anesthesia. However, I estimate that 80 to 90% of my patients prefer and are comfortable with local anesthesia.

How does Ellevate compare to surgical neck procedures?
Although they are not the same as Ellevate, older invasive techniques such as the open corset platysmaplasty were great procedures to use if a patient is undergoing a neck lift or a facelift, or if the patient is older and they really want their neck defined. Many of today’s cosmetic surgery patients do not want an invasive procedure as it carries risk, as well as significant time off from work.  They prefer the Ellevate procedure because they are not interested in invasive surgery, but  want effective results that last a long time, and that’s where I think the sweet spot is for Ellevate.

How does a patient generally feel after an Ellevate procedure?
Most patients report that within a few weeks they feel great. Any swelling or bruising, should dissipate within the first week. After that, patients are going to feel a little bit of tightness where the Ellevate suture strands have been placed especially when they look down towards their toes because that’s when it really does its maximal supporting and shaping underneath the jawline. They may also feel a little pressure behind each ear as the suture loop circles around before it comes down to underneath the chin, so when they look down it pulls a little bit behind the ears. That sensation is pretty much gone by 2 to 3 weeks and after that they’re usually not aware of the pulling sensation.  When we review them one, two and up to six years out, we ask them to look downward and we can still see that Ellevate is still doing its job supporting, refining and  shaping the back part of the neck.

What advise do you offer to a surgeon that is new at performing the Ellevate procedure?
With any new procedure there is always a learning curve and so with new doctors to Ellevate the first thing I tell them is to select an appropriate patient. Patient selection is everything, with every technology and every approach that we do. Finding the right patient, finding the young female or male patient who is just starting to show some signs of aging, with a small amount of skin laxity are ideal as they will have a great result and feel more confident about their appearance. Learning how to comfortably pass the ICLED® Suturod underneath the skin and how tight to tie the suture may take time but once the surgeon learns it, there is no looking back. The second opportunity I would offer is to consider how Ellevate can enhance other procedures surgeons may already offer such as laser and RF skin tightening, liposuction or Kybella®. Our surgeons are finding that these procedures when combined with Ellevate ‘are creating a beautiful harmonious appearance of the lower face, neck and jawline of their patients.

What other types of procedures or technology does Ellevate compliment?
The most exciting technology is the FaceTite® technology by InMode.   InMode also offers another application called BodyTite®.  Both applications work by using radiofrequency which is bipolar meaning that it is very focused and very precise.  It’s a great technology that tightens the skin. So, with my patients now who normally would have required the old traditional neck lift of facelift with all the invasiveness and the incisions and  down time, I now use FaceTite® to significantly tighten skin without any incisions. I have found that whenever I am using a device to tighten the skin or to reduce fat I combine them with Ellevate to insure the absolute best and long term results.

To learn more about Ellevate, visit www.MyEllevate.com.

To learn more about Gregory Mueller, MD, visit www.drgregmueller.com

To listen to Dr. Gregory Mueller’s interview at Aesthetic InsiderRadio,  CLICK HERE!

The post Ellevate™ – The Next BIG Thing In Facial Rejuvenation! appeared first on Aesthetic Insider.

Aesthetic medical science is currently experiencing a scientific revolution. Until recently, full invasive surgical procedures such as Facelifts or Necklifts were the only choice for many patients, however, a recently introduced procedure called Ellevate has been met with great interest by the aesthetic medical community. In this interview with Aesthetic Insider, Florida based plastic surgeon, Adam J. Rubinstein, MD, a pioneering early adopter of the new Ellevate minimally invasive procedure for lower face, jawline and neck rejuvenation discusses why he chose to train in the Ellevate procedure and offer it to his patients. As with all new scientific technologies and procedures, the early adopter pioneers such as Dr. Rubinstein are critical to the growth of aesthetic medicine and its best practices because they are the surgeons who perform new procedures using new technologies that will ultimately help shape and set the medical standards and surgical protocols for the next generation of surgeons. Dr. Rubinstein discusses his work with the new Ellevate procedure as well as the new ICLED® light guided suture rod system, which is necessary to perform the Ellevate procedure.  To learn more about Dr. Rubinstein, visit www.dr-rubinstein.com. To learn more about Ellevate visit www.MyEllevate.com

How did you become an early adopter of the Ellevate procedure?
Beverly Hills plastic surgeon Dr. Gregory Mueller is the inventor of the ICLED® which was first called iGuide. The ICLED® is a light guided suture rod and with it we are able to perform procedures to enhance the lower face and neck which, as a plastic surgeon, really helped me during surgery. Using that same technology Dr. Mueller has refined it and developed the Ellevate technique.  As I have been using the ICLED® technology and Ellevate technique at my practice for some time, it made sense for me to become an early adopter of Ellevate and to actually train other doctors at my practice in Miami, Florida. I pride myself on offering innovative treatments to my patients and believe Ellevate is going to be a real game changer for people seeking minimally invasive rejuvenation of their neck, as it offers a real impact and great results.

How long have you been performing this procedure?
Ellevate is relatively new, but I have been performing the neck defining suture version for patients with a great deal of laxity in the neck using the ICLED® for a more advanced and invasive procedure called the Trampoline Platysmaplasty, for several years. Ellevate is a simplified, non-surgical approach that helps younger patients who are beginning to see a little sag in the neck area and want to firm things up. Giving their neck that extra support makes a big difference in their overall facial appearance. So, overall, I have actually been performing the Ellevate procedure for many years, and more recently have applied it to patients seeking a non-surgical method to refine the lower face, jawline and neck.

How long does it take you to perform the Ellevate procedure?
As I have several years of experience performing the ICLED procedure it takes me less than one hour to perform. In general, once a doctor is trained and has become comfortable with the Ellevate technique, it should take one-and a-half hours from start to finish.

Can you explain how the procedure works?
Ellevate is performed under local anesthesia and, using the ICLED system we are able to very elegantly leverage the connections between the skin, the glands and the muscles in the neck to refine the jawline and neck area. What I mean by that is we use the ICLED and suture rod to strategically place a stich (suture thread) that is weaved towards one ear and back across the neck to the other ear, and  then back to the middle of the neck from where it starts. Once the threading has successfully been placed, the thread is tied to pull back the glands and muscles causing the sagging or neck protrusion. Once elevated to the correct position we can immediately see the definition and result and the suture thread is able to lift the very firm tissue as leverage to lift the whole line across the neck at the angle where the chin and the neck form.  The Ellevate procedure is a very elegant way to refine the jawline and neck without making an incision under the chin, and without dissecting down to the muscle as we would do if we were performing surgery.

Why do you think this procedure is becoming popular among surgeons?
Well, there are several things that are going on with this procedure that provide great benefit, the main one being that we can get a great, long term result in the neck area without surgery.  Other benefits are the ability to offer a neck defining procedure to a younger patient and the fact that the downtime is so minimal makes this a great procedure for both patients and doctors alike, hence its popularity.

Who is the ideal candidate/patient for this type of procedure?
Ellevate is a great procedure for a younger patient – perhaps 30s to mid- 40s – who have a small amount of excess fat under the chin, what we call the submental fat pad, and perhaps sagging of the glands in the neck and a jawline that is just beginning to descend. As we age, the muscular support in the neck weakens and the glands begin to show causing more sagging and requiring support. Ellevate can help set back the clock back significantly for those patients and within an hour or so can improve those three things giving them a much more refined and younger appearance. Ellevate gives doctors an option for patients I call the ‘in- betweeners’ who are patients that are just beginning to show signs of aging but are not yet  ready for a full facelift or neck lift (or do not want a full facelift or neck lift). It is a procedure that has allowed me to give that patient an option without having to do a big surgical operation, and without having to put them under anesthesia as Ellevate can be performed using local anesthesia.

Can Ellevate be combined with other techniques or technology?
Yes. I frequently combine this technique with fillers and skin resurfacing, as well as radiofrequency devices, and a new device that uses plasma and radiofrequency combined. Ellevate lends itself very nicely to any device that is going to help add firmness to the skin.

Is Ellevate the same as a thread lift?
No, however, many people misunderstand the procedure because when we say we use a suture thread, then PDO or other thread lifting techniques come to mind. Ellevate is in no way shape or form anything like a thread lift. Thread lifts are temporary. They only provide about six months of improvement before they absorb and the patient has to return for another procedure. Some patients do get a nice improvement but it’s just not something that I’ve been impressed with. Thread lifts may be a nice alternative for lifting certain parts of the face temporarily if that is what the patient and doctor choose, however, a regular suture thread is not strong enough to hold the very strong and heavy glands and muscles in the neck. Only the long lasting Ellevate suture thread is capable of holding that weight and it does not absorb making it as close to a permanent solution as possible.

How long does the Ellevate procedure last?
I performed my first Ellevate procedure (using the ICLED®) for the first time about 6 years ago and that patient’s jawline and neck area still looks great. Since then, I have refined and performed this technique hundreds of times and each patient shows marked and long lasting improvement.

What can a patient expect during recovery from this procedure?
The Ellevate procedure is actually pretty simple to recover from.  Patients may have a little bit of bruising and some swelling due to the tunneling required to place the thread, or from sub-mental liposuction if that was included. The suture itself does not leave any kind of mark and there may be a little bit of dimpling for the first 24 hours but that goes away quickly. Patients generally return to work within a day or two, and their neck may feel tight or firm for about two weeks but, again, this quickly dissipates as the patient (and the brain) adjusts to the new firmness.  We do ask that patients refrain from heavy lifting or gym activities for two weeks which is normal with most of our procedures, but they can instantly go back out in public perhaps wearing a collared shirt, or neck scarf to hide any short term bruising.

Where do you teach other doctors how to perform the Ellevate procedure?
I have taught doctors from all over the world how to perform this procedure but Dr. Mueller is, of course, the guru. As I have been involved with ICLED® and now Ellevate for some time, I often have other doctors on the East coast that want to learn first-hand how to do this procedure so I open up my Miami practice to them and we have done several training seminars in Miami, FL and across the country on the ICLED® device and Dr. Mueller often joins us to demonstrate his approach to the more refined Ellevate technique when possible.

To learn more about Ellevate, visit www.MyEllevate.com
To learn more about Adam Rubinstein, MD, visit www.dr-rubinstein.com
To listen to Dr. Rubinstein’s interview at Aesthetic Insider Radio, CLICK HERE!

To listen to the interview with Dr. Gregory Mueller the inventor of the ICLED and Ellevate procedure CLICK HERE!

Gregory Mueller, MD

To read the Aesthetic Insider news article “The Next BIG Thing In Aesthetic Surgery” featuring Dr. Gregory Mueller CLICK HERE!

ABOUT ELLEVATE
The Ellevate procedure and the ICLED® light guided suture system is a new minimally invasive and advanced option that, when used in combination, will tighten sub dermal ligaments to better define facial features. Ellevate is not a facelift, necklift or threadlift.  It is a minimally invasive procedure that addresses the muscles and glands of the neck and uses a clear uncomplicated method that allows a surgeon to tighten the neck by effectively placing sub-dermal sutures using the innovative patented ICLED® light guided Suturod® system which easily identifies not only location but also the correct depth of suture placement. When combined with the ICLED® suture system, Ellevate safely and easily delivers exceptional patient outcomes with precise accuracy, reliable and reproducible results. For patients who want to improve/rejuvenate neck contours, the lower face and jawline, Ellevate takes approximately 1 hour and is easily performed under local anesthesia. This procedure can be effectively combined with energy based technologies that tighten skin/dissolve fat/ remove fat and can also improve facelift or necklift results. By smoothing out the targeted treatment area and effectively sculpting in and around the neck, Ellevate can dramatically enhance results. For more information visit www.myellevate.com, or call 310.498.2102.

The post Ellevate™ – Shapes The Future of Facial Surgery appeared first on Aesthetic Insider.

A cherished friend, colleague and icon in the field of Oculoplastic surgery, Henry I. Baylis, M.D., (1935 to 2017) who was Founding Chief of the UCLA Stein Eye Institute’s Division of Orbital and Ophthalmic Plastic Surgery sadly passed away last year. To honor his remarkable legacy in both academic medicine and ophthalmology, the Stein Eye Institute has established the Henry I. Baylis, M.D. Fund in Orbital and Ophthalmic Surgery with the goal to raise $2,000,000 to establish an administrative endowed chair to be held by the division chief of orbital and ophthalmic plastic surgery. In this exclusive interview with Aesthetic Insider, Robert Goldberg, MD, the current Chief of Ophthalmic Plastic Surgery at the Jules Stein Eye Institute/UCLA, discusses Dr. Baylis’ many contributions to JSEI/UCLA and his many contributions to the field of facial aesthetics and ocular plastic surgery, the legacy left behind after his passing and the intent to raise additional financial contributions to this fund. It is the hope of many that if the necessary funds are raised over time the possibility that the Dean of the David Geffen School of Medicine at UCLA may convert the fund to establish an administrative endowed chair to be called the Henry I. Baylis, M.D. Chair in Orbital and Ophthalmic Plastic Surgery, to be held by the chief of the Division of Orbital and Ophthalmic Plastic Surgery. To learn more about Dr. Robert Goldberg, visit www.uclahealth.org/robert-alan-goldberg. To learn more about the Henry Baylis, MD fund and to donate click here.

What is your role as Chief of Ophthalmic Plastic Surgery at Jules Stein Eye Institute?
I’ve been here for thirty years on the faculty, and as the Chief of the division I have run a prosperous fellowship program which was a tradition started by Dr. Normand Shorr and Dr. Henry Baylis. We have a busy clinical service seeing many patients both locally and from an international referral in complex Oculofacial disease. I feel privileged to be in this role and to follow in the footsteps of such visionaries and leaders as Dr. Baylis and Dr. Shorr.  Being part of the JSEI/UCLA campus daily is inspiring to me as it is an environment that is both challenging and rewarding and to be around so many bright minds in medicine is very rewarding to me as both a surgeon and a professor.

How did Dr. Baylis branch out to Jules Stein Eye Institute?
He began his practice in the San Joaquin Valley when the ophthalmology program at UCLA was also beginning. Dr. Baylis discussed the idea of beginning a program in oculoplastic surgery at UCLA with Bradley Straatsma, MD who was a Director at UCLA at the time. Dr. Straatsma gave him enormous encouragement and supported the UCLA CME courses, truly envisioning oculoplastic surgery as part of a robust academic ophthalmology program and he gave Dr. Baylis a faculty position.  At the time, this was a radical idea, and the combination of Dr. Bradley Straatsma and Dr. Henry Baylis starting this program unequivocally instigated our fields, in addition to UCLA.  Around the country, other programs began to learn and observe how plastic surgery could be part of an academic vital ophthalmology program which Drs. Straatsma and Baylis in actuality invented.  For example, Dr. Baylis began doing facelifts in the 1980’s, which at that time was certainly unorthodox for an ophthalmologist to do a facelift and now is a co-requirement of ophthalmic plastic surgical training around the country. Additionally, orbital surgery and orbital decompressions were never performed by ophthalmologists and today it’s a core ophthalmic plastic surgery procedure. When Dr. Baylis began, oculoplastic surgery was a hobby. He truly was an ophthalmologist at the end of the day and would do cataract surgery and do one eyelid case, and it wasn’t even a serious sub-specialty, but he had this vision of a robust specialty which it has become worldwide.

Tell us about Dr. Henry Baylis’ contributions and what made him so special?
Dr. Baylis was the Founding Chief of the division and was never given financial compensation from UCLA.  His involvement in the university was all volunteer and he remained highly involved from the beginning, truly running the program for many years. He was such a joy and lit up every room that he entered and was a phenomenal teacher, not only humorous, intelligent, and dedicated, but his heart was centered on helping young people. He supported our fellowship program, it was his passion, and he personally helped me enormously in my career even after I was the Division Chief, he would check in often and backed me in any way that he could.  Initially, he had incredible push back both from ophthalmologists and other specialties. Ophthalmologists didn’t understand the vision of having robust plastic surgery to be part of our specialty, and other specialties were threatened by someone else in their area of expertise. However, when you look at the field today, ophthalmic plastic surgery has stepped up among the other core aesthetic medical specialties which is largely due to Dr. Baylis’ incredible contributions to the field.

What is the purpose of the Henry I. Baylis, M.D. Fund and what will the contributions go towards?
We want to truly honor Dr. Baylis because his role in our specialty was pivotal. He thoroughly envisioned, supported and developed the entire specialty of what is now referred to as Oculoplastic Surgery. Our goal is to honor that innovation and the imagination that he brought to our field, and to honor his name by starting a Henry Baylis Fund at UCLA. The fund has been established by the chancellor’s office and it’s an official campaign. Our goal is to raise two million dollars ($2,000,000. USD) which would make this fund a chair. It will be a Henry Baylis Chair in Ophthalmic Plastic Surgery at UCLA. Dr. Baylis would have particularly been proud to have his legacy in this fund and chair because teaching and working with the young fellows and developing young careers was ultimately one of the most important things to him. Dr. Baylis’ legacy is magnificently reflected in this academic fund which will go towards teaching, research, and patient care at UCLA in ophthalmic plastic surgery. I hope this chair will commemorate him and perpetuate because the tradition he started in the multi-disciplinary aesthetic surgery field is now ingrained into our DNA as part of the teaching program.

How can people contribute to that fund?
The fund is open and people can CLICK THIS LINK to learn more about the fund or support it. This fund is going to bring incredible joy to all the patients and trainees and faculty that are going to be touched by it and, hopefully, that will be able to carry on and extend his legacy and keep developing the vision that he brought to our specialty that ultimately made it come alive.

To learn more about Dr. Robert Goldberg, visit www.uclahealth.org/robert-alan-goldberg.

To learn more about the Henry Baylis, MD fund and to donate CLICK HERE.

To listen to Dr. Goldberg’s full interview at Aesthetic Insider Radio CLICK HERE!

The post Dr. Henry Baylis: His Contributions To Oculoplastic Surgery appeared first on Aesthetic Insider.

A great smile is something that is often overlooked by cosmetic and plastic surgeons when it comes to facial aesthetics. While reconstructing a nose or enhancing an eyelid might be good for facial symmetry, to obtain true facial harmony it is sometimes the dentist that provides the total balance to a person’s face. In this interview with Aesthetic Insider, Beverly Hills Cosmetic Dentist, Laurence Rifkin, DDS, discusses the importance of looking at the smile of each patient and addressing their dental needs along with their facial aesthetic treatments. This combined approach by aesthetic surgeons and cosmetic dentists can provide the patient with the true, balanced and harmonious appearance they have been seeking. To learn more about Laurence Rifkin, DDS visit www.drlaurencerifkin.com.

How does having a beautiful smile affect a person and those they interact with?
Having a beautiful smile really comes from the inside out. However, the way a person feels about themself is how they are perceived by the onlooker. As human beings we respond to what we see. For instance, if a person is missing a front tooth or they have a chipped or stained tooth, they tend not to smile and try to hide that perceived blemish so when they interact with others they don’t smile. Therefore, they are not perceived as friendly, likeable or as approachable as they would if they just smiled. A facial expression has a two-way neuropsychological effect upon our psyche, so our self-esteem is affected, and when a person cannot just smile it affects their relationships with the outside world. In business for instance, when a person is going for a job interview or interacting with clients or customers or even patients, if they cannot generate a warm, friendly, confident smile, it may lessen their chance of success. It can also affect personal and romantic relationships because it can make a person withdraw, or appear withdrawn. A smile doesn’t mean the person has to have perfect teeth,  but a beautiful, natural looking healthy smile really is inviting because it’s the communication center between all of us.

When I speak for instance, people focus on what I’m saying and the facial expression that supports my spoken content. So, when a person hears words, they look directly at the mouth that creates these words, they are observing the lips, the teeth and gums, they are looking at the eyes (as humans we gaze back and forth and these are the two important facial features when we look at one’s face) and it gives us the perception of beauty, of honesty and integrity, and so they focus on that. This really comes back down to neuropsychological genetic studies. Dr. Konrad Lorenz won a Nobel Prize for understanding beauty. The concept of beauty itself is really interestingly and comes from our appreciation of our children, of our young. We perceive beauty as youthfulness. Also evolutionary it has been proven that general body symmetries, left and right symmetries, support health, so an animal or a creature that has a physiological or anatomical asymmetry sometimes is not as healthy as one that is symmetrical. Let’s say you have one leg shorter than the other, you probably can’t run as fast or perform whatever functions you need to do. When doctors examine patients and find a lump on one side of the body and it’s not on the other, they have to investigate it. It may be nothing but it could be an indication of some health issue. So, symmetry and youthfulness is a form of beauty, and when we look at one another or when we look at ourselves, if we see some blemish in some way, shape or form, we lose that positive confidence in how we look at ourselves, our self-esteem and how others perceive us, as well as how we perceive others. Therefore, having a beautiful, natural smile and using it when we interact with others, can have a very positive impact on all of our relationships.

What are the principle factors you consider when creating a beautiful smile?
As a cosmetic dentist, patients usually come to me to improve their smile through cosmetic dental treatments such as veneers, tooth whitening, etc., rather than for their general dental health which is a very important foundation that should never be ignored just for cosmetics. We always have to start with the foundational health. But when I look at someone who wants to improve their smile, I have to look at why they’re coming to me in the first place. If a person wants to improve their smile, they generally want to look their best and know that their teeth are just one aspect of their overall appearance. However, because I am a dentist they don’t always realize that I may or may not have the knowledge to consider other areas of their facial aesthetics, such as their nose, eyes or neck, that can be improved. My background lecturing at the AACS (American Academy of Cosmetic Surgery) and at LA-MCA (Los Angeles Multi-Specialty Cosmetic Academy) and professional relationships I have developed over the past thirty years with many plastic surgeons, facial plastic surgeons and dermatologists, has broadened my knowledge of facial aesthetics that I can share with my patients whom I often refer to my colleagues for other procedures. The principle factors I consider when creating a beautiful smile is a matter of balance, an artistic balance. I look for balance, symmetry and harmony and not just in the teeth and lips, but also in their personal features. I look at their eyes, nose, cheekbones, chin, etc., in relation to their smile and consider their full profile. By analyzing the face from the front and from three-quarter profiles, I can see how the lips, gums and teeth appear in relation to the attributes of the face and its structure and from there I can plan how to build the best and most beautiful smile that I can.

How often do you refer patients to colleagues in plastic and facial plastic surgery?
Quite often actually. I developed the Rifkin Method which is my system of interviewing a patient to determine whether or not they are also interested in other aesthetic procedures besides their teeth. Over the years what I found is that dentists have been isolated by the patient (which is understandable), and the plastic surgeon has been isolated by their patients also. Therefore, through the Rifkin Method I have developed a network of super-specialists that work with the patient and puts them in charge of their overall facial aesthetics. This way the patient can choose what they believe is the best strategy to get them the smile and appearance they truly want.

Does overall facial aesthetics require a team approach?
I believe that we have to work as a team. I work with surgeons, I work with orthodontists and in some cases, I even work with makeup artists and hair stylists to help the patient put together the most ideal, pleasing features for them. Of course my focus and expertise lies in improvement of the teeth, mouth and smile, but the other aspects of facial and physical harmony that the patient is seeking has to be very personalized to each patient. Every face is unique like a fingerprint and you have to put together those facial elements in a harmonious fashion and it takes a variety of specialists and experts to do that.

Why did you develop the Rifkin Method?
Over my thirty plus years in practice I have developed a great deal of trust among my patients who come from all walks of life and who often asked me what else could be done to help them look younger, or more vibrant. They would tell me that they had been referred to a plastic or cosmetic surgeon by a friend, or they had seen somebody on a TV news show or digitally on the Internet and they were not sure if that person was qualified or not. So it occurred to me that for those patients I could ask a series of questions and then put them in touch with the other expert team members I have developed relationships with over the years and they could make their own selection in terms of which specialists they want to work with who understand the full concept and integrated, comprehensive approach to facial beauty.

What steps to you take in your patient analysis to determine their course of treatment?
To begin with, I look at the patient’s goals. I talk to them from a heart-to-heart standpoint of what it is they want to achieve. Not everyone is concerned about whether their face is symmetrical or not which is fine, and not everyone needs or wants a lot of cosmetic dental or cosmetic surgery work either.  I’m a believer that if a procedure is not indicated, or the patient does not want other enhancements because they are secure in themselves and with their own appearance, then great. Their inner confidence is going to present a great, warm and friendly smile and to me that is what is most important. During the initial exam, I look at what their goals are and I take two and three dimensional photographs from multiple views, as well as three dimensional radiographs or x-rays such as CT scans (which have incredibly low radiation) to look at the internal skeletal structure and I put together a personalized power point presentation that the patient and I review together. This way they can see their face, their mouth, their teeth and every aspect possible. After discussing their dental needs and next steps in terms of what (or if) cosmetic dental or other enhancement is required, I will address any other blemish they might want corrected and, if there’s an indication, I will communicate and work closely with the preferred plastic/cosmetic surgeon or dermatologist to provide further improvement.

How does cosmetic dentistry provide the patient with a more harmonious and balanced appearance and what elements do you apply when working with plastic and cosmetic surgeons to help patients attain their desired end result?
The sub-specialties in facial aesthetics each work on a different area of the face, i.e., the oculoplastic surgeons provide improvement to the eye and forehead area, the plastic/cosmetic/facial plastic surgeon provide improvement to the face, neck, cheekbones, chin, eyes, etc., and the dermatologist provides improvement to the skin and so on. The cosmetic dentist, of course, provides improvement to the teeth. What is important to understand is that the underlying structure, whether it is cheekbone or tooth is very important to the end result. Let’s take, as an example, a patient that has poor lip support. Their teeth are either small or they’re tilted inward and they have a change in their profile from the nose to the lip which we call insufficient lip support. That same patient wants to have fuller lips and goes to a plastic/cosmetic surgeon for lip enhancement. After injection, however, they look like they have fat lips that completely hide the teeth and make the teeth look even smaller in appearance. My approach would be to bring the teeth forward whether by orthodontics or cosmetic dental enhancement first, and then have the plastic/cosmetic surgeon provide lip fillers to create a perfect, balanced smile.  If the plastic/cosmetic surgeon does the lip enhancement without understanding how the teeth might become hidden by the increased lip volume, the patient will then come to me asking for bigger teeth which would not give them a harmonious, balanced appearance as the teeth would be too large for the face.  The same considerations can be applied to chin and cheek augmentations, as well as rhinoplasty.  In the case of a deficient chin, a plastic/cosmetic surgeon might put in a chin implant, or inject a filler along the jawline to create a stronger definition. However, I would first look inside the patient’s mouth to see if their bite is incorrect and is causing a weak chin or an asymmetrical jawline, and correct that before suggesting a surgical or filler procedure. The goal of doctors and dentists is to provide a balance, symmetrical appearance to the patients face and this can be achieved better when we work together.

Are orthodontics popular with older patients?
Yes. In more recent years we have seen an increase in both patient interest in orthodontics and in dental improvements with features such as Invisalign and other tooth straightening devices. Of course, it’s better to start orthodontics at a younger developmental stage when we have more control of facial growth, jaw formation and jaw bone size. When we get older, we can move teeth to some limited degree, and teeth do wear and shorten overtime so orthodontics or reconstructive dentistry can impact and correct that. Some of my patients always wished they had worn braces as a child to correct crooked teeth, and as an adult tooth straightening becomes important to them.

What other aspects of cosmetic dentistry improve overall facial aesthetics?
I like to do the minimal amount of tooth modification with veneers or crowns if we can avoid it, and sometimes orthodontics can do that. Tooth whitening and, of course, veneers. Veneers have come such a long way in recent years in terms of color, shading, texture, etc. Most veneers I perform these days look completely natural and suit the patient’s skin color, and facial shape. My goal is to refine everything that I do and that includes the step-by-step approach I have to creating a great smile including doing wax sculptures of teeth and provisionals (temporary teeth) so that my patients can try on their new smile first to make sure they are happy with the result before finalizing it. Plus the new ceramics we use are wonderful and look completely natural.

How can plastic/cosmetic surgeons work better with cosmetic dentists for overall patient improvement?
The new LA-MCA aesthetic meeting that was recently held in Beverly Hills, CA, was a great start to truly bring together all the specialties involved in patient aesthetics, head to toe.  I have spent many years attending and lecturing at aesthetic meetings such as those held by the AACS and more recently LA-MCA as I have wanted to improve my understanding of cosmetic surgery so I can be better prepared for my patients. I think the more understanding that plastic/cosmetic surgeons gain of the importance of teeth to the underlying, and overlying facial structures, the better results their patients will achieve overall.

Dr. Rifkin displays a relentless passion for excellence in periodontal health, function and dento-facial aesthetics. He creates synergy between science, technology and fine arts. He also believes in a team approach to achieving optimal results for his patients, collaborating with both dental and medical specialists he’s personally hand-selected for their skill and integrity.

To listen to Dr. Laurence Rifkin’s interview at Aesthetic Insider Radio, CLICK HERE!

READ MORE ABOUT DR. LAURENCE RIFKIN IN THE ARTICLES BELOW.

“Beverly Hills Cosmetic Dentist Shares Love of Art With Fellow Dentists At AMED”

“When Hollywood Smiles!”

To learn more about Dr. Rifkin, visit www.drlaurencerifkin.com and www.suite1200.com.

The post How Important Is The Smile To Overall Facial Aesthetics appeared first on Aesthetic Insider.

Aesthetic medicine has now reached an exciting tipping point with the use of a new generation of PDO (Polydioxanone) Threads that allow aesthetic doctors the ability to deliver exceptional non-surgical aesthetic results. In this interview with Aesthetic Insider Arash Kalantari, CEO of Med Results, Inc., distributors of the innovative and advanced FDA cleared ASsufil threads, explains why ASsufil is now considered the new gold standard for advanced longer lasting absorbable threads. Manufactured in Italy by the leading European thread maker Promoitalia, ASsufil are a completely absorbable, safe, and effective non-surgical alternative for some short-term facial and body lift procedures. Not only do they deliver exceptional patient results, but when strategically marketed to aesthetic patients will also have a significant benefit on an aesthetic practice’s bottom line. To learn more about ASsufil, visit www.med-results.com

How did you begin your career in the aesthetic medical industry?
My education and background is in medicine and I have always had a passion for medical innovations and technology so my wife Zara and I founded a company called Medaria in 1999 that works in the medical industry in Europe and the Middle East and now has over fifty-five employees. In 2015, we founded Med-Results here in the USA and we have now become active in the aesthetic market with ASsufil PDO Threads and also our own patented technology for feminine rejuvenation called Higgs.

What made you first become interested in the PDO Threads?
After the success of our company Medaria, I was looking for technologies that were trending as well as those showing actual growth in the market and PDO Threads rated high. What drew my attention was not only that the growth rate was high, but they had been redesigned to offer more benefit to the patient. I try to use my knowledge of medicine and my knowledge of technology to solve problems especially when it comes to aging and I found that the new uses for PDO Threads and their market potential to be very exciting.

Why do you think PDO Threads are one of the fastest growing procedures in aesthetics?
For years we have been talking about obtaining natural results in aesthetics but less than a decade ago cosmetic surgery results such as lip fillers for instance did not look natural.  There was also a trend a few years ago where people were talking more about what surgery they had, or were discussing their laser hair removal publicly. Nowadays people are much more secretive again about their cosmetic procedures and they want natural results. Everybody wants to say that this is my own face, this is my own body and I didn’t receive any kind of surgical assistance. PDO Threads can create a natural result and they are not risky compare to surgery. Therefore, PDO Threads being non-surgical and, when performed by a trained doctor, are natural looking have become the obvious choice by both patients and doctors making it one of the fastest growing aesthetic procedures available.

What makes ASsufil the Gold Standard?
ASsufil is an FDA approved product like some of the other PDO Threads available, however, I believe that the ASsufil thread is produced to a much higher manufacturing standard than some of the others on the market. ASsufil is produced in Europe – Rome, Italy to be exact – in a facility that follows European medical production guidelines exactly. The production facility in Italy owns the technology to manufacture the PDO substance and manufactures the actual Thread which makes it very unique and proprietary. ASsufil threads have a great track record and when compared to other threads are considered by many to be of far superior quality.

Can you explain Polydioxanone?
Polydioxanone or PDO is basically a polymer and, it seems, a polymer that the body is familiar with and one that has little to no reaction in the human body. It has been used for surgical suturing for decades and is considered extremely safe to use. Normal polydioxanone is made to be absorbed as in the case of absorbable stitches during surgery, but for cosmetic rejuvenation purposes it needs more longevity so that it can last for several months to years. In terms of longevity, the PDO that we manufacture to create the ASsufil HD-PDO Thread is medically designed to be high density HD more durable and long lasting and that’s why doctors are having such a great result with this HD-PDO product.

How are the ASsufil HD-PDO Threads different?
The polymer that we use for ASsufil is made for lifting, it’s made for rejuvenation. It’s not made for suturing, so it’s totally different. The crystallization and the quality of this HD-PDO is also different than normal PDO and we are able to offer different types of PDO Threads. For example, one of our series of PDO Threads last between six to eight months, and another series lasts up to two years. Also, we have created a special device which was designed in Italy and is responsible to create the barbs equally. One of the important features of these new generation PDO Threads is that the barbs must be created equally so that they lift the tissue and create the same amount of collagen or microfibrosis necessary for asymmetrical results over time. Another important device we use scans every single barb in the production line and if a piece of thread is not exactly similar it does not qualify which makes the ASsufil HD PDO Threads unique.

How long can a patient expect an ASsufil Thread lift procedure to last?
It really depends on which kind of procedure they are going through. The minimum length of time is eight month for some indications, to eighteen months for other indications and some of the threads last up to three years.

What areas of the face and body do ASsufil HD PDO Threads work best?
What I admire most about the ASsufil Threads is the natural result they create and the variety of indications we can treat with them. We basically have many different kits suited to different treatments. My favorite is what we call the OMG Kit named because when patients first see their result they always say, “OMG – I love it.” Another favorite is the Beverly Lift Kit which is more specific to the face, cheek, marionette lines, etc.  Overall the ASsufil threads work very well on many areas of the face and body including frown lines, eyebrows, periorbital area, as well as the breast, buttocks, knees, and underarms as well.

Can a patient maintain their appearance once the thread has absorbed?
One of the great things about ASsufil PDO Threads is that due to the quality of the thread and the amount of collagen production – microfibrosis – that is attained even after two of three years is generally very good. After time, a patient will most likely require more threads to be placed but not as much as with their first procedure as the collagen production will last, therefore, they will require only a few new threads for maintenance.

Are any incisions required with this technique?
No that is a thing of the past. The new threads do not require incisions and, in most cases, very little if any anesthesia or injectable numbing solution. With our more recent techniques and the quality of the threads we use, most patients are comfortable with a topical numbing cream.

What other procedures work in combination with PDO Threads?
Fillers and neurotoxins, as well as treatments that improve skin tone and texture work really well with PDO Threads. Often times, a doctor can use less filler as the threads provide a nice lift. The other procedure that works well with thread is PLEXR, plexr is our new method for excess skin reduction. People who are using threads are aware of the fact that if you can get rid of the excess skin along with threads, the achieved results will be super exciting. We have training courses on non-surgical blepharoplasty as well using plexr technology.

Does Med-Results offer training to doctors on the ASsufil PDO Thread?
Yes. Every thread has its own technique and with ASsufil we offer two different trainings all across the USA. The training is a key point for us and is based on true medical indications and results. It’s not based on what we can provide, it’s based on what a doctor can provide to a patient using our technology and our product. During the training we go over each indication and we teach our attendees how to use a thread to attain an exact clinical result which we have found is really important to the doctor. I’m very proud of our training sessions.

To learn more about Med-Results and ASsufil PDO Threads, visit www.med-results.com

To watch an ASsufil training video, CLICK HERE!

To listen to Arash Kalantari’s interview at Aesthetic Insider Radio, CLICK HERE!

The post ASsufil Threads: The NEW Gold Standard in PDO Thread Lifting appeared first on Aesthetic Insider.

The Ellevate minimally invasive facial rejuvenation procedure is currently attracting massive US and international attention from plastic, facial plastic and cosmetic surgeons, as it is the first non surgical procedure to offer long lasting rejuvenation to the neck, lower face and jawline. In this interview with Aesthetic Insider, Professor James D. Frame FRCS, FRCS(Plast) who is internationally recognized for his academic leadership in plastic and reconstructive medicine as well as a pioneering early adopter of Ellevate at his UK medical practice, shares an international perspective on how Ellevate is rapidly becoming the procedure of choice for patients and surgeons.  To learn more about Professor Frame, visit www.professorjamesframe.co.uk. To learn more about Ellevate, visit www.myellevate.com.

How did you learn about and become interested in the Ellevate procedure?
For the last 8 years I have been a professor of aesthetic plastic surgery at the medical school at the Anglia Ruskin University in Chelmsford Essex. In 2008, I was visiting San Francisco for a medical conference and I received an invitation to observe Dr. Gregory Mueller, who was demonstrating a new facial rejuvenation technique that used a new technology called the ICLED®. I became interested because Dr. Mueller was demonstrating how to lift up the hanging part of the neck under the submental (or below the jowl/neck and lower jaw) and to say the least I was very impressed. I then thought, ‘we’ve got to use this in the United Kingdom’ and I invited Dr. Mueller over to our hospital in the UK where he demonstrated on a number of patients in a very expert manner. We then used the ICLED and what has now become the Ellevate procedure on approximately 50 cases with excellent results.

What has changed since then?
Originally we had an early version of a tool now called the ICLED® which is a fiber lighted rod containing a long suture. The ICLED® tool has been modified as well as the Ellevate technique which has been simplified and adapted to fit virtually all patients. Previously Ellevate was only the Trampoline Plastysmaplasty which Dr. Mueller still performs on more advanced patients and still trains on, but what has changed is that the original procedure has been modified and adapted for more widespread use and to meet the demand of a younger patient.

Can the Ellevate procedure be used in conjunction with other treatments?
There are certain people that need adjunctive treatments. It’s not just all about the neck, sometimes you have to include other procedures such as little mini face lifts or facial tightening, fillers and fat graft or energy tools to tighten the skin.  We can adapt the technique to suit our patient needs and I’m really quite excited about incorporating it into my practice in the United Kingdom.

How long did it take you to learn the Ellevate technique?
It’s quite easy for most surgeons, you just follow one line to the next line and the suture is easy to tie. It’s a better, more simplified procedure than when it was first developed.  You can actually see the way Dr. Mueller has studied and analyzed the anatomy and worked out the direction of pull that is going to make the lower neck pull up nicely. The problem with virtually all surgeries on the neck is that we cannot necessarily solve the lower part of the neck itself and Dr. Mueller’s Ellevate technique does that.

What are the drawbacks with a surgical approach to facial rejuvenation?
If you just do a facelift, the neck doesn’t always come up with the face as well as we (both doctor and patient) would like. In fact the evidence is that the face stays up well, but the neck drops back within three to six months. The muscles and glands in the neck are heavy and are what makes it hang. So we needed to develop something to keep it in place. Surgical options include extensive undermining and high risk surgery, to just work on the submental area. It includes an incision underneath the chin and releasing of tissues, taking out fat, tightening the muscles of the neck and the platysma muscle and then suturing it in place. This can often leave the patient with a significant amount of lumpiness and irregularities that take a long time to settle down. With Ellevate we don’t need to be so aggressive and the results are very good.  One drawback is the quality of skin on the patient. If the skin is aged and not able to retract, then it may hang slightly but most patients see this as a minor issue.

How is the non surgical Ellevate procedure different?
The idea of putting the skin into a position where it’s higher and tighter attains a very reasonable result with a good angle. Ellevate is actually doing something quite simple. As surgeons we are always attempting to provide a great patient result with the least downtime and very low morbidity. Ellevate is a low risk procedure with very high reward, whereas surgery is a high risk procedure with high reward. Most patients prefer the low risk option.

What makes Ellevate a notable procedure?
The day after the procedure the patient is up and about and, apart from a little bit of tightness in the neck, they are able to immediately resume normal life as long as they follow post-operative instructions. There is very little downtime and no scars. The needle holes used to insert the suture rod disappear within days and you can hardly see anything.

How does the ICLED® tool help perform the Ellevate procedure?
The Ellevate technique sutures are placed in an anatomically defined area by using the ICLED® tool. The ICLED® tool has a light source at the tip generating a white light creating visibility to guide the suture rod through and into the plane of the neck between the skin and the muscle, the platysma muscle.  If we go outside of the muscle by elevating that muscle, we are actually pulling it in behind and that includes the submandibular glands and all the lateral parts of that. The neck is moved up into a position that’s suspended between the two mastoid processes, which creates a basic suspensory sling, but it’s not one line, it’s actually two lines of thread which draws it and pulls it all together giving a nice definition. Generally we will have liposuctioned the tissues above it, so we are basically closing off space so therefore there is less risk of a hematoma or a seroma, and less risk of infection. The ICLED® tool uses a fiber light that glows white yellow when it’s in the right plane, but if for any reason the rod moves behind the muscle it will show brown or red and that is the signal to the surgeon that they are in the wrong plane. The ICLED® gives the surgeon a great advantage over any other techniques as they are not doing a ‘blind’ surgery, they are able to easily see and place the sutures in the correct anatomical position.

What is the difference between the suture technique used in the Ellevate procedure compared to PDO Threads?
Threads are quite thick, are fairly rigid and the suture material has little semi-cuts made into them that we call barbs. The idea is to insert this suture thread through the tissues in the right direction so that the barbs are not anchoring anything. Then when you pull the thread from the other end, it actually catches the tissues by anchoring the barb and pulls the tissue back. There are certain tissues that the barbs won’t hold and in other cases when they do hold, sometimes on very thin people, they can actually tent and distort the whole facial anatomy. In addition, you never really know what plane you are putting the PDO thread suture and to suspend the thread lifts to try and lift up the neck they are not able to go across the neck in the way Ellevate can and if they did they could actually be garroting the tissues. Also, PDO Threads and the barbs will dissolve and will give way in the tissues (anything under tension gives way) so they are a temporary phenomenon. I don’t know any surgeon that’s experienced good long term result with any barb type of facelift, virtually always the effect is gone, if there was any effect at all, at 3 months. Compared with the Ellevate procedure where a patient can expect a result that will last a lifetime because the sutures we are using are non-dissolving, non-barbs solid suture material that is expertly placed to hold the weight and remain well hidden. There is really nothing that compares to it.

Who would be the ideal surgeon to perform this technique in the UK?
There’s a turf war that has been going off for the last 30 years which is absolutely unnecessary.  Plastic surgeons by and large don’t own the right to do cosmetic surgery, and I think we will have to accept that In Australia, England and in the United States. The junior surgeons have recognized they’re not being trained in cosmetic surgery. If we take the fact that most newly qualified plastic surgeons are inexperienced and they’re going to learn ‘on the hoof’, the best advice is to go and see somebody that actually does this type of technique and actually receive training. It’s incumbent upon surgeons like me to say ‘look, I’m not just going to train plastic surgeons, I’m willing to train head and neck surgeons, oral surgeons, anybody that is interested in doing safe surgery that I think is competent enough to do it.’   I happen to have trained such surgeons in all sorts of techniques over the last ten years and I can tell you some of the general surgeons are as good as the plastic surgeons.

To learn more about Professor Frame, visit www.professorjamesframe.co.uk.

To learn more about Ellevate, visit www.myellevate.com.

To listen to Professor Frame’s radio interview on Aesthetic Insider Radio, CLICK HERE!

Gregory Mueller, MD

To read the Aesthetic Insider news article “The Next BIG Thing In Aesthetic Surgery” featuring Dr. Gregory Mueller, the inventor of Ellevate,  CLICK HERE!

Adam Rubinstein, MD

To read the Aesthetic Insider news article “The Next BIG Thing In Aesthetic Surgery” featuring Dr. Adam Rubinstein, MD, CLICK HERE!

ABOUT ELLEVATE
The Ellevate procedure and the ICLED® light guided suture system is a new minimally invasive and advanced option that, when used in combination, will tighten sub dermal ligaments to better define facial features. Ellevate is not a facelift, necklift or threadlift.  It is a minimally invasive procedure that addresses the muscles and glands of the neck and uses a clear uncomplicated method that allows a surgeon to tighten the neck by effectively placing sub-dermal sutures using the innovative patented ICLED® light guided Suturod® system which easily identifies not only location but also the correct depth of suture placement. When combined with the ICLED® suture system, Ellevate safely and easily delivers exceptional patient outcomes with precise accuracy, reliable and reproducible results. For patients who want to improve/rejuvenate neck contours, the lower face and jawline, Ellevate takes approximately 1 hour and is easily performed under local anesthesia. This procedure can be effectively combined with energy based technologies that tighten skin/dissolve fat/ remove fat and can also improve facelift or necklift results. By smoothing out the targeted treatment area and effectively sculpting in and around the neck, Ellevate can dramatically enhance results. For more information visit www.myellevate.com, or call 310.498.2102.

The post ELLEVATE™ Captures The International Aesthetic Community appeared first on Aesthetic Insider.

Dr. Walter Tom

Obtaining a beautiful and vibrant youthful appearance is seen and understood differently by everybody. For some people, aesthetic beauty comes naturally. For others a quick visit to a cosmetic surgeon can make the world of difference. In this interview with Aesthetic Insider, Dr. Walter Tom, a Cosmetic Surgeon who practices in Santa Rosa , CA, discusses how he and his staff use a broad array of advanced aesthetic technologies, products, treatments and procedures to safely deliver natural and beautiful looking results to all of his patients. It is Dr. Tom’s unique, educational and collaborative style of consultation with his patients that helps him develop realistic and reasonable expectations which ultimately deliver excellent results and happy patients. Read on to learn more about Dr. Tom’s approach to cosmetic surgery, as well as the most current and up-to-date trends in aesthetics. To learn more about Dr. Walter Tom, visit www.drwaltertom.com.   

How long have you been practicing cosmetic surgery?
I was always drawn to the cosmetic surgery world and realized that dream when I created the Aesthetic and Laser Vein Centers initially in Santa Rosa, California just over eighteen years ago. I now also have an office in Napa Valley, California and two years ago opened up a practice on the island of Maui, Hawaii.

Have you seen a growth in cosmetic surgery procedures?
Yes I have. Not just in the number of new cosmetic surgery patients to my practice, but also in the demand for both surgical and non-surgical procedures.  Over the past eighteen years there have been many new developments especially in terms of fillers, injectables and technology as it all relates to aging. When we started in 1999 we had a laser for laser hair removal, an IPL (intense pulse light) for facial rejuvenation or what we call photo facial treatments, but then we began to see many new developments driven by consumer demand and by our patients. What we saw was an evolving array of techniques that became less invasive and delivered better results with no downtime and little in the way of recovery. Surgical skills and procedures also advanced bringing in better and safer breast implants, tumescent liposuction techniques and much more. There’s been a movement towards less invasive procedures or if you do need surgery, techniques that will hasten the recovery for a patient. It’s been very impressive.

Why is patient education important to you?
Education of all kinds is key for me. It is important to me to spend time and to educate all my patients on the procedures they select, and I believe in educating my colleagues and peers, as well as myself. As a former President of the California Academy of Cosmetic Surgery, it was very important to me to learn as much as I could from colleagues in all aesthetic specialties, and to share as much of my own knowledge with others as I possibly could.  It is my belief that educating patients is the best thing we can do for them, and ourselves.  I generally spend a good hour or more with each patient at their initial surgical consultation with me. The more a patient understands about their chosen procedure, the better experience they will have and ultimately the happier they will be with their result. Giving a patient a great result and making them feel happier about themselves is of utmost importance to me.

What can a new patient expect when they consult with you for a procedure?
First, an understanding that there’s no one perfect solution for any particular problem, so the first thing I do is listen to the patient and find out what are their concerns, where they are in their life, and why are they requesting an alteration or an improvement in their cosmetic appearance. If we listen to the patients and fully understand their motivation, we have a better chance of being able to help them to achieve that. My new patient consultations generally last about one hour, I look into the patient’s eyes, look at their general health via their skin condition and then look at the overall appearance of their face, or body, and examine them depending upon what procedure they are requesting.  I will discuss all of the procedures available to address their particular issue, provide any necessary reading material, show them before-and-after photos or videos if the procedure they are requesting requires a video description and answer any questions they may have. We review photos to show them what they might expect and, in some cases, may actually refer them to another surgeon for a procedure we may not offer. The most they can expect is a thorough and educational consult that will hopefully answer all their questions and leave them confident about the solution they have chosen.

How do you approach facial aging and facial rejuvenation?
That’s a challenging question as we have patients in all age groups so facial rejuvenation to a person in their 20s is different than that of a patient in the 60s or 70s.  However, my base approach is the same in terms of evaluating their eyes, their skin health and their ultimate objective. How we treat each patient is where the variance comes in. Younger patients generally have good or adequate facial volume, while the aging patient often experiences loss of fat in the face which decreases their overall volume and the face looks deflated. One of our first approaches with facial aging is to restore volume via facial fillers and/or fat transfer to the face.  Fat transfer is one of my niche procedures and something I lecture on frequently. It is a procedure wherein we take fat from another area of the body, possibly the abdomen or inner thigh where it will not be missed, process it and reinject it into areas of the face showing loss of volume. This is my preferred method as it is natural to the patient, is long lasting and rarely develops any complication. My main approach to facial aging and facial rejuvenation is a non-surgical approach that includes botox and fillers, fat transfer, and skin restoration for which we offer a variety of options including lasers and IPL, hydrafacial, topical skin treatments and at-home skin-care solutions. For me, less is more and many times a patient might need a few minor treatments to obtain a phenomenal result.

Can you help a patient that has neglected their face and has sun damage?
Of course, although their results might not be as good as someone who is entering the world of cosmetic treatments at an earlier age, or someone who has refrained from sun bathing and smoking and not neglected their face.  Many of the new laser and RF (radio frequency) treatments work wonders on the skin and can very effectively reduce fine lines and wrinkles leaving the skin looking brighter and firmer. Neurotoxins such as Botox® can help significantly with crow’s feet and wrinkles, and we are seeing exceptional results with fat transfer and PRP (platelet rich plasma) to restore volume loss.

What is PRP (Platelet Rich Plasma) and how do you use it?
PRP is serum from our blood and it contains various healing factors. It is the serum that occurs in a cut or a scrape and acts to heal the tissue. It is derived from the blood and processed and we often use it to help rejuvenate the skin when we do microneedling. With microdneedling little tiny tunnels are made in the skin and the PRP helps heal those tiny wounds and helps create collagen formation. I use it for fat grafting too because it improves the longevity of the fat and also improves the texture of the skin. We also use it in combination with fillers as it increases the life of fillers, and we use it in hair transplants too. Hair transplants are a very common procedure for both men and women and we soak the hair follicles in the PRP, or we can actually inject PRP in an area where there’s a lot of hair, and it can many times stimulate hair growth in that area.

Do you have any cosmetic ‘secret’ tips?
Ha ha. Well yes I do.  With aging, the area underneath the eye sometimes loses fat and begins to look dark and hallowed. Patients think that their skin has changed color when in fact it is generally shadowing caused by loss of light bouncing off the skin under the eyes. Light from the sun or fresh light in a room would normally hit below the eye, but when the area under the eye is sunken the light goes straight to the floor missing the lower eye area completely. By simply restoring fat to the lower eye area, the light will hit the fat pad under the lower eye and bounce that light directly into the pupil causing it to shine brighter making the patient look happier and more youthful. Another secret to restoring youth to an aging face is to add a little fat to the cheek or malar area. A fuller cheek is a sign of youth and a simple way to refresh and lift an aging face, and when that patient smiles the cheek is lifted higher catching more light which again is reflected in the eyes causing them to sparkle even more.

What is your approach to aging of the body and is the Mommy Makeover a lasting trend?
I do think that being a mom is probably one of the most wonderful things in the world, but many moms do experience changes in their body due to pregnancy that they want to correct. I do think that Mommy Makeovers will be a lasting trend although in my practice they begin with women in their 20s and continue up to women in their 70s who are now grandmothers. For those patients, depending on how their body has handled the pregnancy, we would typically offer a breast lift or augmentation, liposuction and/or a tummy tuck.  However, we do have non-moms who come in seeking breast augmentation, reduction or lifts, as well as liposuction and tummy tucks.  My approach to aging is to help our patients achieve their desired look. For some patients this actually starts with personal changes in diet and exercise so they can reach a weight loss goal before having a surgical procedure. For others, it might be that they want a breast augmentation or a simple liposuction procedure only as they are perfectly happy with the rest of their body.

What procedure is the biggest confidence booster in a patient?
Breast augmentation has one of the highest satisfaction rates of all the cosmetic procedures that we do and continues to be within the top ten most desired cosmetic surgery procedures nationwide.

Are male cosmetic surgery procedures on the rise?
Definitely. For the gentlemen at my practice body contouring tops the list.  Some of them have what we call a ‘muffin top’ of excess fat and skin that hangs over the back of their pants so liposuction of the back area, abdomen and flanks is very popular. We are also experiencing an increase in our male patients asking for facial procedures and we have to be careful not to feminize their faces in any way. Men differ from women in that some of them have very strong jawlines while others have heart-shaped faces. If you simply compare George Clooney to Brad Pitt you will see what I mean. Both are extremely handsome but their facial structure is very different and we have to take that into consideration when doing Botox® or filler procedures on the men.

What are the current top cosmetic procedures?
If we include surgical and non-surgical, I would say these are the current top cosmetic procedures:

• Botox® and Fillers
• Skin Resurfacing Lasers
• PhotoFacial/IPL
• Microneedling with PRP
• RF Skin Tightening
• Breast augmentation
• Liposuction
• Tummy Tucks
• Hair Transplants

What do your patients say about your practice(s)?
Our patients are generally bringing us something about themselves that they do not like and are actually very vulnerable.  By recognizing that, my staff and I do our best to treat them how we would want to be treated and I think what they would, and they do say, is that we treat them nice, we show our care and concern for their well-being and are truly happy to say they are our patients.  We strive to make them feel special and I think they would agree that we do.

For more information about Dr. Walter Tom or to learn his hours of operation in Santa Rosa, CA, Napa, CA and Maui, HI, visit www.drwaltertom.com.

To listen to Dr. Walter Tom’s interview on Aesthetic Insider Radio, CLICK HERE!

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 LOS ANGELES CONFERENCE BRINGS TOGETHER WORLD LEADERS IN AESTHETIC SURGERY

Aesthetic industry leaders Kian Karimi, MD of Rejuva Medical and Angela O’Mara and Giles Raine of The Professional Image, Inc., knocked it out of the park with the LA-MCA conference that attracted over 400 attendees and 40+ medical device companies who gathered at the Four Seasons Hotel for the most innovative and inspiring event.

Joining up with Hollywood, a special Keynote Speech was delivered by entertainment industry veteran and icon Ted Gagliano, President of Post-Feature Production at Twentieth Century Fox, whose “Medicine and Movies! The Magic of Technology” presentation received a standing ovation as it covered decades of movie making magic, as well as the newest frontier in medicine – 3D imaging – showcasing revolutionary technology and 3D goggles developed my Magic Leap with the future enablement of brain mapping and other medical breakthroughs.

Among the exciting and ground breaking techniques and technologies showcased at LA-MCA 2019, Ellevate, a new procedure developed for lower face, jawline and neck rejuvenation was presented by Beverly Hills, CA plastic surgeon Gregory Mueller, MD. Dr. Mueller, whose lifelong work has gone into the refinement of the Ellevate technique which uses patented ICLED® light guidance, continued with a workshop and live training at his Beverly Hills practice. Steven F. Weiner, MD, of Santa Rosa Beach, FL presented his own unique combined approach to jawline enhancement using Fillers and RadioFrequency in what he calls his “Rejawvenation” technique and Shino Bay Aguilera, DO presented new uses for Sculptra that took the group by surprise.

“All in all, the LA-MCA 2019 meeting brought together leaders from across the country and around the world with a shared vision and dedication to providing the best in aesthetic education,” said Dr. Karimi Course Chairman and co-creator of LA-MCA. “I was proud that we were able to execute this four day program with multiple workshops, and off-site trainings from Beverly Hills down to USC School of Medicine with flawless precision.”

Other noted and well-received presentations were Facetite plus Morpheus 8 and Accutite from InMode, BBL Advanced Light Techniques from Sciton, Profound RF from Syneron-Candela, as well as special workshops showcasing advanced injection technique with a variety of products from Allergan, Galderma, Merz and Revanesse VERSA.

“Intertwining Hollywood elite and glamour with the LA-MCA makes perfect sense as much of our consumer ideals in beauty come from Hollywood actors and actresses,” stated Angela O’Mara, Program Director and co-creator of the LA-MCA along with Dr. Karimi. “Los Angeles is the world epi-center of plastic surgery and with the many breakthroughs in medical technology that were showcased at the LA-MCA 2019 it will continue to lead the world in medical aesthetics.”

A Full Program and list of speakers is available at www.cosmeticacademymeeting.org.

Multi-Specialty Cosmetic Academy (MCA), a California based aesthetic medical educational organization hosts the LA-MCA meeting and the 2019 program was comprised of over 65 leading physician speakers, 40 medical device companies, and  multiple training workshops, including two cadaver dissection workshops in Fillers & Injectables held at nearby Keck School of Medicine at USC (University of Southern California.) California is recognized worldwide as the scientific and educational center for aesthetic medicine, and with an ever increasing growth in demand for cosmetic procedures, LA-MCA brings leadership and advanced learning to medical professionals worldwide that can ultimately provide excellent patient results and safe outcomes overall as attendees are offered a wide variety of learning opportunities. MCA offers year-round learning, webinars, podcasts and events to its members at www.multispecialtycosmeticacademy.org. LA-MCA 2020 will be held March 26 – 29, 2020 at the Four Seasons Hotel on Doheny Drive in Los Angeles. Call 949.768.1522 for more information.

The post MEDICINE MEETS THE MOVIES appeared first on Aesthetic Insider.

While facial aging might be a part of life, keeping and maintaining a youthful, natural appearance is becoming more accessible with the introduction of HDPDO Threads, a new non-invasive approach to turning back the clock. Dr. Martin Kassir, a board-certified Dermatologist who practices at Kassir Dermatology in Dallas, Texas, explains to Aesthetic Insider the importance of this new approach to facial aesthetics and why Threadlifts have become so popular among patients from many different age groups and ethnicities. To learn more about Dr. Kassir, visit www.kassirdermatology.com. To learn more about HDpdo Threads, visit www.HDpdo.com.

Dr. Kassir, please explain to our readers your approach to cosmetic dermatology.
I’m a board-certified dermatologist and have been in practice in Dallas and New York for the past 20 years. I have concentrated on non-invasive aesthetic procedures, with a specialized expertise in lasers, energy-based devices, injectables, needling techniques such as PDO threads and ethnic skin treatments. I also teach internationally and have been an instructor and lecturer in lasers and aesthetics in over 40 countries. This has given me the privilege of seeing how doctors (dermatologists and plastic surgeons) perform procedures in other countries and as I have a very diverse patient population it has helped me treat patients with all skin types and age groups which has been very helpful in both Texas and New York. My approach is unique in that I treat each patient individually and I can customize aesthetic treatments that address their specific needs, skin type and age.

How did you first become interested in offering HDPDO Threads to your patients?
It is very interesting because the Threadlift technique is very non-conventional, however, aesthetics procedures are evolving at a very fast pace and the non-invasive procedures doctors are able to offer are continuing to grow and expand rapidly. My initial foray into aesthetics was with lasers and, in my mind, threads relate to lasers because they are both scientific and they involve a lot of physics, i.e. lasers with light and how it interacts with skin tissue, and threads based on the technology on the threads itself. Threads come in a variety of smooth and barbed forms that work at various levels within the tissue, so the thickness of the threads, the thickness of the barbs, if they have barbs on them or not, the length of the barbs, the angle of the barbs, the distance between the barbs, all act differently within the tissue. Previous thread technology on the market had not impressed me and I was waiting for the ideal threads to become available and the HDpdo Threads are very close to what I envisioned as the ideal type of thread. So, once this came on the market, I was very enthusiastic about using it from a clinical standpoint and was able to rapidly move forward with offering this technique in my practice.

What are PDO Threads?
PDO stands for Polydioxanone. PDO Threads are basically made from suture material that has been used in medicine for 30 to 35 years especially in the cardiac and pediatric surgery fields. The suture material has since evolved into becoming usable in the aesthetic field. As mentioned earlier, some of the other threads that have been used previously weren’t ideal because they would break easily, couldn’t hold tissue effectively, and some of them dissolved too fast. The newer PDO Threads now do two things. The barbed threads can move tissues slightly and elevate it, and the smooth threads have shown to induce a collagen reaction that helps develop new collagen. Therefore, the PDO Threads can both improve the quality of the skin which is very important, and they reposition the skin giving the patient a smoother, tighter appearance.

What areas of the face benefit the most from the PDO Thread technique?
PDO Threads can be used on many parts of the body, but what I have concentrated on mostly is in facial contouring. We can do cheek enhancement, lift the jaw line and the brow area and in some patients improve the periorbital area of the face. The periorbital area can be a challenge with traditional fillers and injectables especially on a patient with deeper lines and wrinkles. With the PDO Threads in this area, we can lift the tissue and improve the skin quality by building up collagen. Overall, we can improve crow’s feet, forehead lines, sagging cheeks, upper lip volumization and skin laxity; also, these principles can be applied to other parts of the body.

With PDO Threads do you see a difference between ethnic skin and non-ethnic skin in terms of lifting?
When we use lasers or perform light-based procedures ethnic skin is more easily burned or can become damaged more easily because light gets absorbed in higher quantities in ethnic skin types. With threads, because there’s no light involved it is sort of color blind, thereby the effect is the same in ethnic and non-ethnic skin types. What I can tell you specifically about threads and ethnic skin is that ethnic skinned people tend to not develop as many wrinkles at as early an age as let’s say Europeans or lighter skinned people. So, typically, ethnic skinned people might present a little later and with less damage to be repaired so we can do more with less in ethnic skin.

Who is the ideal patient for a HDPDO Thread procedure?
Anyone can benefit from the HDPDO Threads. The ideal person is someone that does not have good skin quality and they’ve had a lot of collagen loss due to sun damage, genetics or aging. However, if they have mild to moderate laxity of the mid-face and jaw, and marionette lines, they would be a really, really good candidate. If a patient has excessive laxity and volume loss, they are probably candidates for surgery, but if the laxity is mild to moderate, they will benefit from HDPDO Threads. But, it’s just like anything else that we do, each patient needs to be individualized and treated according to their specific needs and what I find is that most patients (almost all patients) need a combination of treatments.

What other aesthetic procedures do you combine with HDPDO Threads, and how would a patient get started?
We first evaluate everyone with clinical and polarized photography so we can see under their skin and get an insight into not only what’s already happened but what’s going to happen as they continue to age. That’s a very important first step. Then we address level of wrinkles, skin laxity and overall skin quality, as well as eyes, lips, cheeks, chin, jawline, etc. to determine the best approach to meet their goals.  If the patient has dynamic wrinkles or wrinkles because of movement, we will combine HDPDO Threads with a Botulinum toxin to stop the movement. Once the muscles stopped moving then you’re decreasing the rate of breakdown of the collagen and so forth. And then if they need volume, we can add volume loss by using a variety of facial fillers. In other areas such as the lower cheeks where we really cannot use Botulinum toxin and they don’t need volume, we may combine a laser or light therapy skin tightening treatment with HDPDO Threads. With so many great fillers and toxins available now, we are really able to address all aspects of facial aging using a wide variety of technologies including laser light and radiofrequency combined with HDPDO Threads to give a patient a natural and rejuvenated youthful appearance.

How long do HDPDO Threads last?
I’ll answer that in two parts. The first part depends on what they needed and how aggressive a treatment was performed in the first instance. If the patient wants a very aggressive, turn back the clock significantly procedure, the result will last longer. However, some patients don’t want a drastic change but rather a slow progression of treatments that while still offering a beautiful, rejuvenated appearance, might need for them to come in for smaller, maintenance treatments more often. HDPDO Threads are designed to absorb over time and as they absorb, they continue to build collagen in the tissue which gives a longer lasting result overall.

How is a HDPDO Thread procedure performed?
The threads are folded and loaded on to very, very small thin needles which are inserted under the skin and threaded gently into place. Once the needle is pulled out, the threads remain underneath the skin anchoring the tissue in place. It is what I call a “technique dependent procedure” and I recommend that patients go to experts in the field to obtain a great result.

Is there any discomfort with this procedure?
I’ll tell you an interesting point. Other than things such as tattoo removal, I usually have procedures done on myself before I ever do them on patients because I really want to know what they’re feeling. So, I had a considerable number of threads put into my face so I could experience this technique. Now, as a male, my pain threshold is not anything near that of a female and I’ll readily admit that with no shame, but the pain associated with HDPDO Threads to me is very tolerable. We only use topical anesthesia and for the conventional threading we don’t need to make any incisions other than just inserting the needle as I’ve related before. The interesting thing I’ve learned from having had them done and then performing the procedure on my patients is that if the needle is inserted in the right plane or the correct skin layer, you don’t really feel much and neither does the patient. So, my having the procedure performed on me first has given me very good insight on how to best perform this technique on a patient.

How long can a patient expect to spend recovering from a HDPDO Thread procedure?
When I had my treatment done, I was back to work the very next day. I wasn’t limited and did not have the need to take any time off after my procedure. For most patients, the actual procedure itself takes approximately one to two hours. When the patient arrives for treatment we go over the procedure with them and provide review materials so they understand what they are about to experience, they will do their patient consent and then we begin with sterile prep and getting them comfortably ready for their treatment. The actual HDPDO Thread procedure itself may only take 15 – 30 minutes to perform depending on how extensive a treatment is necessary. Most patients experience minimal bruising and discomfort but obviously the more threads we place, the higher chance of a small bruise. We do screen people to make sure they’re not on blood thinners, or if they are, they stop it at an appropriate period of time. So, age and other medical conditions come into play for both pre- and post-procedure and the majority of patients can continue as normal immediately after a treatment. We do ask that they refrain from swimming, heaving lifting or brisk exercise for two weeks after the procedure.

What pearls of wisdom can you share with our readers as it relates to keeping a youthful look?
Aging is a continuous process and patients can begin a small maintenance program early and by that, I mean preventative skin care, sun screen usage, botulinum toxins in the early to mid-twenties to prevent crow’s feet, good health, limited alcohol consumption and no smoking are all things a patient can do to retain their youthful look.  Then, of course, we have fillers, laser treatments and HDPDO Threads that a patient can incorporate as they age. Starting preventative care at an early age is the best pearl I can offer but for those that did not, fortunately we now have many advancements in aesthetic treatments that really can help a patient obtain a renewed and revitalized appearance.

Dr. Martin Kassir can be reached in Dallas, Texas at 214-360-1500 and readers can visit his website at www.kassirdermatology.com. To learn more about HDpdo Threads, visit www.HDpdo.com.

To listen to Martin Kassir’s interview at Aesthetic Insider Radio, CLICK HERE!

The post Kassir Dermatology Defines The Art of Aesthetic Beauty with Threadlifts! appeared first on Aesthetic Insider.

There are many different aesthetic treatments available to patients, however, HDpdo threadlifts are trending as a top choice among patients. In this interview with Aesthetic Insider board certified dermatologist Dr. Brenda LaTowsky, who has served as an investigator for many research studies on cutting-edge cosmetic technologies, and the latest innovations in cellulite and minimally-invasive body treatments, discusses why her patients choose a new non- surgical PDO (Polydioxanone) threadlift using HDpdo Threads in combination with a broad variety of advanced technologies to deliver natural looking solutions for anti-aging and skin rejuvenation. To learn more about Dr. LaTowsky and Clear Dermatology her Scottsdale, Arizona practice, visit www.cleardermatology.net. To learn more about HDpdo Threads www.HDpdo.com.

How did you first become interested in offering HDpdo Threads to your patients?
PDO stands for Polydioxanone and that product has been used in surgical procedures for many years. It has been commonly used in dermatology as a surgical suture but these new non-surgical PDO threads are really very exciting for lifting skin and tightening skin. There is another thread that uses a different compound, Polylactic acid, and that’s a little bit more volumizing. What I like about the PDO threads is that they lift and tighten while adding firmness to the skin which creates an amazing result for the patient. In terms of the high-density threads, that’s something that sets HDpdo apart and that’s one of the reasons that I chose them. High density means that the threads are manufactured under high temperature and high-pressure conditions which results in a thread that is finer and very durable. Therefore, we don’t need to use a thick thread and have been able to reduce side effects.

HDpdo threads are manufactured in Italy? Does that make a difference?
One of the reasons that I use this brand exclusively in my practice is because it is a very high quality thread with a very good track record. Many Italian products do seem to be of a very high quality so I do think it makes a difference. It’s also been an eye opener as to the many applications of these threads. Many times my patients tell me they feel their eye lids are drooping more, or that their eyes don’t look as awake and alert as they used to and rather than do an eyelid surgery, we are able to use a smooth thread which looks like a delicate fishing line in that area to create more structure and firmness to the eye area. Patient’s love it! Many times the patient has lost collagen in the tissue and the thread creates a small firmness and, over time, as the body breaks down the threads, it creates collagen where the thread has been and gives a long lasting result. I can use this same technique to treat around the eyes, and the mouth. We are now also able to use threads to provide structure around the mouth that gives the lips a nice, slightly pouty look without adding any volume which is something that appeals to a lot of patients.

What other areas of the body do you treat with HDpdo Threads?
The main areas I treat are the eyes and lip area as mentioned, but also the jawline and neck but, for many patients we can add threads to the abdomen to give them a little bit of tightening in the stomach area which is really good for women who have had multiple children. A lot of times, they will get some lax skin in that area so when we add the threads there it provides firmness and then, as mentioned before, long-term collagen production without volumization which patients love because it makes the skin firmer. More recently, we are using the threads in the buttocks to perform a non-surgical buttock lift which we can combine with body contouring, cellulite treatments and so on.

Who is the ideal candidate for a HDpdo Thread treatment?
That’s the beauty of this technology or this method. There are so many different applications and, therefore, many great candidates. For a younger patient who just wants to slow down the aging process a little bit but doesn’t want to look over-filled or unnatural, we can gently firm the jaw line and provide more lip definition naturally. Then when we move to the older patients we can easily lift the jowls and firm up the jawline and neck to provide a very youthful appearance. Then, as mentioned previously, for moms or an aging patient who wants added firmness to the abdomen and buttocks, we can use threads there too. HDPDO threads can really apply to almost everyone seeking aesthetic improvement of their face and body.

What is the downtime associated with a HDpdo Thread treatment?
Well, when we’re talking about the face, it really can be quite variable. I would say most patients have little to no downtime. There is a risk of bruising, however, it’s usually very slight. Most patients do experience very minor swelling but nothing really noticeable. For the most part, patients may feel a little bit of tenderness where the thread was inserted but that dissipates over the course of a few days. The neck area does have a slightly higher chance of bruising because the skin in thinner. Off the face, there can be a slightly more soreness in the buttocks or in the abdomebecause those areas are larger and are generally in more constant motion.

Do you often combine HDpdo Threads with other aesthetic treatments?
It really depends on the patient, the quality of their skin tone and the result they desire. If a patient has great skin texture and tone or maybe had a resurfacing treatment in the past, or uses quality skin care  products, avoided the sun, etc., they are more likely to have good collagen and the threads may be very effective as a stand alone treatment. If someone has more damaged skin and needs volumization I often work in combination with other products, such as Sculptra which is poly-L-lactic acid that is injected and grows overtime. We can do many combinations of fillers, neurotoxins, micro needling and laser treatments and we may do them at one time, or more often work on the skin tissue and volumization and then a few weeks later do a second treatment with the threads.

Are body treatments performed as a combined treatment also?
Oftentimes, I do recommend that we combine the Sculptra on the abdomen and the buttocks when I’m treating those areas. If you’re talking about the buttocks, a lot of patients will have some cellulite and by adding Sculptra, which will stimulate the body’s collagen and help to even out the skin tone and texture, we can improve the tone and texture of the tissue. Then, when we go back a few weeks later and put the HDpdo Thread underneath the skin, it binds that new collagen and is very effective. The Sculptra often act as as a lifting agent in the buttocks as it will help to lift the skin that gravity has pushed down over the years and we are seeing some really nice results from the combination of Sculptra and HDpdoThread combinations.

How long do threadlifts last?
Every patient is individual, as is their treatment plan and result duration. With threads results get better as collagen growth replaces the thread itself.  I ask patients to return at six months to review their progress. At six months some patients may need a little more treatment and with other patients we may decide to not do another treatment for some time.

How long does it take to recover from a HDpdo Thread procedure?
I always recommend patients go home and rest after any aesthetic  treatment. With HDpdo Threads recovery takes a few days in terms of potential bruising, swelling and soreness as mentioned earlier.  I do prefer that patients refrain from heavy exercise and activity for one to two weeks so as the thread can become one with the internal tissues. Threads to the face do not pose as much of a threat when it comes to heavy exercise or lifting, but with body threads we do have to be a little more careful.

What is your most popular HDpdo Thread procedure?
Threads to the face, especially the lower face, jawline and neck have been the most popular. But the newer areas of eyes and lips and body threads are catching up very quickly as patients are really loving the results of thread lifts.

Dr. Brenda Latowsky can be reached at Clear Dermatology in Scottsdale, AZ at www.cleardermatology.net. For information on HDpdo Threads., visit www.HDpdo.com.

To listen to Dr. Brenda Latowsky’s interview at Aesthetic Insider Radio,

CLICK HERE!

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A defined jawline is often seen on runway models and for most aesthetic patients is a desired appearance. In this interview with Aesthetic Insider Steven F. Weiner, MD, a Facial Plastic Surgeon and Head and Neck specialist located in Santa Rosa Beach, FL, discusses his many years of experience in the use of facial filers and radiofrequency devices that has led to his “ReJAWvenation” technique. After making a conscious decision 15 years ago to lay down his scalpel and focus on non-surgical options for facial rejuvenation, Dr. Weiner has realized the exciting possibilities of products and technologies that safely and rapidly deliver aesthetic rejuvenation and anti-aging results to his patients. This has inspired him to develop an aesthetic medical practice that exclusively uses minimal and non-invasive aesthetic treatments to bring long lasting beauty to his patients from all over the world. To learn more about Dr. Steven F. Weiner and his ReJAWvenation technique, visit www.theclinique.com.

Dr. Weiner, how did your aesthetic practice develop?
I’m a Johns Hopkins trained Head and Neck, Facial Plastic Surgeon where I was on-staff for a couple years before going into private practice in Georgia. My practice at that time consisted of all types of head and neck procedures, including facial plastics. However, about 15 years ago I began to notice that patients (and the general public) wanted less downtime so they didn’t have to take too much time from work, and less in terms of recovery, i.e. brusing and bandages. This was around the time when Botox® was FDA approved, and then came the filler Restylane® which also received FDA approved. I decided to open what I called The Aesthetic Clinique on the Florida Panhandle in a small town called Santa Rosa Beach. I took the risk of laying down my scalpel, stopped doing surgery and concentrated all my efforts in doing minimal and non-invasive cosmetic procedures and non-surgical procedures. Since that time I have become quite an expert in filler techniques and lasers and I spend almost all of my time doing injections. I also travel frequently around the world lecturing and doing hands-on training courses and I am one of the biggest trainers for the Galderma company, which is the Restylane family of fillers. My practice in Florida focuses exclusively on non-surgical treatments and we have developed a large following of patients from all over the world.

What changes have you seen in the world of aesthetics over the past 15 years?
The changes have been tremendous. Not only have we seen a massive growth in the number of patients seeking aesthetic procedures, but we have now seen that the number of new non-surgical cases are double and triple the number of surgeries. Fillers, injectables and laser treatments are wildly popular and developments in the field in terms of new toxins and new more refined filler products are available to treat a wide variety of concerns. What I find fascinating is that in many cases I can now do something with a filler in five minutes and without anesthesia, that fifteen years ago would have taken several hours and with the patient being put under general anesthesia. It’s wonderful and I am very excited at what will develop over the next few years.

What is the ReJAWvenation technique you have become known for?
I’ve coined the term ReJAWvenation and I am the ReJAWvenator and our patients get ReJAWvenated. It’s a method of defining and de-aging the jawline but let us first go back a step. As a jawline ages it becomes more irregular and less defined. It doesn’t appear as firm as it was and the eye immediately picks that up as a sign of aging. With ReJAWvenation, there are two parts to the actual rejuvenation. There is the enhancement aspect for new younger patients who really don’t have any signs of aging but want a more distinctive and defined jawline which the eye sees as a sign of youth and beauty. For instance, take a look at runway models in advertisements and other media, they all have very strong jawlines. Athletes and the people deemed to be the most attractive men and women in the world, they all have strong jawlines. I recognized that this was an area that needed addressing and rather than do it surgically with implants, I developed a technique using fillers only. Secondly, there is the aging aspect wherein the patient could have had a stronger, or weaker, chin and jawline and now due to aging are seeing that the skin appears slacker and the jaw is not as firm. Those patients are seeing a result that returns a youthful appearance to their face.

How important is the jawline to your male and female patients?
With the men in my practice, I would say that probably the single most important aspect of their profile is their jawline. Whereas in females the order would be cheeks and lips, with the jawline a close third.

How does the ReJAWvenation technique work?
After studying the aging process of the jaw I have come to the conclusion that the main aspect of the aging process is due to volume loss, loss of skin elasticity, gravity, as well as the boney resorption in the mandible (jaw bone). So what we are doing is actually correcting the bone loss using fillers which in turn improves the jawline making it look firm again. It’s a simple technique where I enter with a cannula, which is larger than a regular needle but the tip is blunt so there is no sharp point at the end. It’s not actually a needle, but a blunt cannula which is extremely safe and comfortable. Our patients consider this as one of the more comfortable procedures they undergo. I inject the gel posteriorly, which means backward towards the ear, and underneath the jawline. I use a variety of different types of fillers depending upon the patient and level of treatment. Some of the fillers are hyaluronic acid fillers such as a Restylane Defyne® and Restylane Lyft®. Both of those are great because they are temporary and reversible so if a patient has any apprehension about the procedure, it can all easily be dissolved with something called hyaluronadase. Other fillers I use in this area are Radiesse® fillers which is a more long term filler lasting anywhere from nine to eighteen months, whereas the HA fillers last around nine to twelve months. For a more permanent procedure I use Bellafill® which creates a collagen response from the body which makes its duration last a lot longer, probably permanent. Once I complete the correction in the posterior, the back aspect of the jaw, I turn the cannula around and correct the area closer to the chin. I like to do the ReJAWvenation technique in two treatments. In the first treatment I inject from one to two syringes per side, again, depending on the patient and course of treatment. At that point I stop and have the patient return approximately four to six weeks later to allow the fillers and jawline to take shape and at that point we can decide if there is need for any further correction.

Do you treat other areas of the face at the same time?
Yes. It is important to treat the entire face. We don’t want to isolate the jaw alone. Often cheek fillers are also used as well as fillers to the preauricular area, which is the area in front of the ear, because this seems to gently pull the skin back from the middle aspect of the face particularly the marionette areas, and it also helps improve the jawline as well.

What is the downtime with ReJAWvenation?
There’s really hardly any downtime with this procedure. Patients are able to go to dinner, go to lunch, etc. I recommend not working out at the gym for the next 24 hours or so but, at most, patients may have a little bit of soreness and sometimes a little bit of bruising but their lives are not interrupted at all.

Please explain how your technique uses both soft and hard fillers
The fillers I use have something called high G-prime. G-Prime is a measurement of the fillers’ ability to lift other tissues. Therefore, we need to use a very thick type of filler in the correction of the jawline, rather than ones that spread out and are kind of pillowy. Those are better placed in other areas of the face or lips. Aging is a process, particularly in the face, that occurs in both hard and soft tissue. The skin becomes a little thinner and crapey, muscles weaken, volume loss occurs and, as mentioned previously, bone begins to resorb. In fact, the decision on what type of filler is based upon some of the soft tissue characteristics and if the soft tissue in the jawline is thin, then we don’t want to structure a product underneath it that will be visible. On those patients, I prefer to use Restylane Defyne, which integrates with the tissues well and does not become as apparent as some of the other products I discussed earlier.

Are current fillers age selective?
The fillers aren’t necessarily designed for certain age groups, but as we continue with research as well as application, some fillers seem to be better suited to a younger and/or an older patient. It is common for me to use two or three different types of fillers in the same patient depending on the level of injection, whether the need is deep or superficial, the area that I am correcting and the need for lifting or the age of the patient.

Has anything happened in recent years that really excited you about this field of medicine?
Well, yes, lots of things and one I found very exciting was when the FDA approved both Restylane Refyne and Defyne. Those products are unique in that they are made with something called expression technology which means they have the ability to stretch and contract so are perfect for areas with animation particularly the perioral area around the mouth, nasolabial, the smile lines, chin area, and marionette area. When  a patient moves their mouth for instance, the filler seems to move too making the action look more natural than with previous fillers that did not have that flexibility. A recent study has shown that these fillers reduce the muscle strain in the perioral area. It showed that a 58 year old muscle strain was reduced to one that was comparable to a 35 year old muscle strain after Refyne and Defyne were place.

How long do the fillers last?
When I’m putting these type of fillers around the mouth where there is obviously a lot of movement, they tend to not last quite as long as areas where there’s not a lot of movement. I tell my patients that Refyne and Defyne in the mouth area will last about nine months.

Are you seeing more millennials in your practice for ReJAWvenation?
Yes. Absolutely. My patients are great at referring friends and family to our practice but we have seen an uptick in millennials that find us on Instagram. Instagram shows a lot of before-and-after photos, not just ours, but all the other practices that use Instagram as a method to communicate with new patients. What is interesting is in many of the before-and-after photo results are difficult to see in some areas of the face due to lighting and shadowing. However, in the jawline it is always more obvious and when patients see their ‘selfies’, it is their jawline that they feel they want to improve, especially men. Millenials are now making up a large number of new patients to our practice.

As a result of increased awarenss of ReJAWvenation, have you seen a surge in male patients?
Yes! For men, it’s all about angles and men prefer a more boxy look. Actually there was a study through Fortune 500 Magazine where they went through the Top 500 companies in the US stock exchange and  reviewed  pictures of their CEOs. They found that 95% of the CEOs had strong jawlines. Strong jawlines are associated with confidence, honesty and with power. In addition, a strong jawline in a male is associated with high testosterone / more fertile and therefore and they are more attractive to females as a mate.

What other aesthetic treatments complement the ReJAWvenation technique?
Great question. I don’t want to pretend that the only treatment for sagging jawlines is filler. In fact, some people need combinations of therapies and one of our more popular therapies is called Genius. Genius is a radio frequency microneedling device that addresses skin tightening issues that aren’t addressed with just filler. Sometimes we use Kybella, a fat melting injection particularly in patients with double chins. There is a newer radio frequency device called FaceTite and more recently AccuTite, which is a little more invasive than the other procedures mentioned but works great in the lower face and upper neck too. ReJAWvenation patients are always really happy to see the improvement to their jawline, and when we are able to complement that with improvement in other areas of the face too they are generally just ecstatic.

Dr. Steven F. Weiner can be reached at 850-622-1214. To learn more about ReJAWvenation and other aesthetic treatments offered by Dr. Weiner, visit www. visit www.theclinique.com.

To listen to Dr. Steven F. Weiner’s ReJAWvenation interview at Aesthetic Insider Radio, CLICK HERE!

The post Why A Defined JAWline Is Seen As A Sign Of Beauty! appeared first on Aesthetic Insider.

Hollywood is known for special effects and, when it comes to Dental FX, producers generally look to Beverly Hills Cosmetic Dentist Laurence Rifkin, DDS for some extra special dental effects. In this interview with Aesthetic Insider Radio, Laurence Rifkin, DDS who practices in Beverly Hills, CA, explains his work on movies such as The Hangover, and the Nelson Mandela TV series working with Laurence Fishburne to create Dental FX to make these shows and the actors appear more realistic on screen. To learn more about Laurence Rifkin, DDS visit www.drlaurencerifkin.com.

Why do Hollywood producers reach out to you to help them create special dental FX in the movies?
I have been in cosmetic and reconstructive dentistry for over forty years and have been practicing in Beverly Hills for most of my career. I have had a multitude of wonderful experiences with patients both in the normal realm of dentistry as well as working with patients who are professional athletes, actors, and models. Professional actors physically transform into their characters not only though their makeup and wardrobe, but also through their teeth which has led many Hollywood producers to reach out to me create special dental FX in the movies.

How does dental FX work when it comes to Hollywood movies, are they regular patients that come in and then they have the need in the show, or just the producers say this is what we want to do in this particular movie and how can you help us?
It comes from both directions. Sometimes it comes from the actor themselves letting me know about their role for an upcoming movie, usually the actor describes the character to me and they say my teeth don’t reflect the character, what can we do? In addition to professional actors, I have Hollywood producers that are also my patients and they will tell me about an upcoming film and the character they want to produce. The producers then ask how I can help with dental FX to transform the actor physically into the character the actor is portraying.

How did you first get involved with doing dental FX?
It began more with repair rather than special effects. I was a team dentist for the Los Angeles Lakers and repaired teeth that were broken during athletic play. I then started to get called down for emergency repairs on movie sets to keep movie productions shooting.  It costs hundreds of thousands of dollars per day to shoot and I initially did emergency repairs for the purpose of the movie, not even special effects, but just to keep the actors looking like themselves.  This emergency repair led to other opportunities, such as working on, The Hangover.  My patient and friend, Mr. Ed Helms who is terrific and starred in The Hangover was playing a character that had one of his teeth pulled out in the movie. Ed and his producer asked how we could make his front teeth look like a tooth had been pulled out. Initially, I gave him the option of blacking out the teeth, but he actually had a crown on one of the front teeth and a dental implant so we removed his crown and during the movie, he actually had a missing tooth. Another fantastic actor, Laurence Fishburne, has natural gaps between his teeth. I fully support gaps that go with your individuality because every face is unique and different, but in the roles that he was taking on such as Nelson Mandela, he wanted to close the gaps to more physically transform into the character. We decided to develop multiple sets of overlay plastic teeth that fit and filled the gaps between his teeth, and in doing so he started to metamorphosis into Nelson Mandela. Closing his gaps also affected his speech pattern because his tongue and mouth had previously adapted to speaking with those gaps. Since we filled the gaps in, it led to another transformation because it affected his phonetics as he ran through lines and developed his South African accent and developed his voice for Nelson Mandela.

In terms of the phonetics influencing the voice and the pitch how you do the special effects so that it’s an easy transition for the actor?
When you add in the changes anatomically of the teeth length or thickness, it affects the space with the tongue and how you annunciate F sounds or S sounds, sibilance or fricatives. Consequently, we have to work with the temporary teeth when we design to start to shape and control the contour to make it the most comfortable transition for their tongue to adapt to that new shape. We continuously refine shapes of teeth to be the utmost natural form, and the actor can readapt to that shape. Temporary crowns are a huge part of our practice both for the person that’s acting and non-acting. When we do a smile makeover, it can also affect someone’s speech and we all adapt to that because over our lifetime our teeth do change, they grow, they change position, and we adapt.  When we do it rapidly in a special effect situation, we have to work with the actor to ensure our contours are suitable for them.

Is there any overlap in terms of dental FX and special things you might build for a patient with a particular dental issue outside of the movies?
All experiences are additive and my experience being challenged to do these repairs in short term and long term and create new characters that have to be able to function and speak has always helped me in my everyday practice with my patients who are just as important to me as any celebrity. If it is a smile makeover, the design process includes photographs, computer imaging models, three dimensional models, digital models, and creating wax sculptures of the new teeth that would be appropriate for that particular patient. As a team of artisans and dentistry professionals, we shape and color the tooth to ensure that it appears undetectable; it looks like a natural tooth. Similarly to dental FX for actors, the non-acting patient also will have their speech impacted which is all a part of the design. We design for the health, function, and aesthetic appearance of a person’s teeth; thus there is considerable crossover in those working experiences.

In terms of people in the modeling industry, is there ever an instance in dentistry where shadowing from lighting might make somebody with a perfect smile look like they have an imperfect smile and that it’s something that you have to fix?
One instance I had was working on a beautiful young actress. In normal lighting, her teeth were slightly crowded and overlapped, but not enough to warrant a whole smile makeover. However, when she was acting everyday with harsh studio side lighting, it tended to create shadows in studio that were not there in normal ambient lighting. Similarly with the models that I’ve worked on, the harsh studio side lighting can create a shadow on the tooth. Frequently, we simply move a few teeth and get them straighter and more aligned to eliminate that overlap which eliminates minor crowding and eliminates the shadowing effect.

How does Dental FX enhance your practice and/or patients?
It has changed my practice by changing my protocol for how I design teeth. It has enabled me to gain experience and knowledge in more challenging cases such as making perfect duplication of teeth that have been fractured. Additionally, it has made me more sensitive to concerns of phonetics and speech, because the typical patient doesn’t always think about this.  It has allowed me to anticipate potential problems with my normal non-Hollywood patients and make their treatment a little bit more predictable and more fun for them as well.

Is there anything on the horizon we should be looking for where your dental FX skills are being used?
Currently, we are working with extremely innovative combinations of treatment and predictability. With today’s technology we can look at the patient from the inside out, observing their skeletal system, which allows us to predict if we change the teeth position, what would that effect be on their smile or their lips. All of these technologies help me in my work for facial aesthetics as well as my other specialists in the medical community of plastic surgery.  We are able to take a patient and look at the skeletal system, teeth, lips, and look at the skin surface and see how we can improve a patient’s function, health, and beauty all at the same time with the new technologies.

To listen to Dr. Laurence Rifkin’s interview at Aesthetic Insider Radio, CLICK HERE!

READ MORE ABOUT DR. LAURENCE RIFKIN IN THE ARTICLES BELOW.

“Beverly Hills Cosmetic Dentist Shares Love of Art With Fellow Dentists At AMED”

“When Hollywood Smiles!”

To learn more about Dr. Rifkin, visit www.drlaurencerifkin.com and www.suite1200.com.

The post Dental FX – Hollywood Special Effects appeared first on Aesthetic Insider.

Leonard da Vinci is considered one of the greatest artists of all time. A painting by him, Salvator Mundi, sold for a world record $450.3 million at auction in New York in 2017, the highest price ever paid for a work of art. Today, Leonard da Vinci continues to inspire artists world-wide and his works, including notebooks, drawings, scientific diagrams and nature paintings have made a significant contribution rivalled only by his competitor Michelangelo. Many aesthetic surgeons and providers of aesthetic medicine are considered today’s modern sculptors of the human tissue and in this exclusive interview with Beverly Hills Cosmetic Dentist, Laurence Rikin, DDS, we discuss the effect Leonard da Vinci has also had on the field of aesthetic medicine. Dr. Laurence Rifkin, a sculptor himself, uses many of the principles Leonardo da Vinci applied to art in his daily cosmetic dental practice and teaches plastic surgeons, cosmetic surgeons and dermatologists world-wide how they too can learn from the masters to bring better results to their patients. To learn more about Dr. Rifkin, visit www.drlaurencerifkin.com.

What is your background in sculpting?
Before I was a dentist, when I was in college, I was an art major and studied all forms and mediums of art which is where I developed a foundation for artistry.  Since my childhood, I knew I had a creative way of thinking and always loved observing objects for their beauty to better understand them. Shortly after college, I discovered my ability to enjoy dentistry through my uncle’s practice. In working in his laboratory, I found I could couple the art skills that I had acquired in college and apply them into a new profession, dentistry, which was extremely exciting for me. The combination of the creative background of art and the health field seemed to be a natural blend together, and as I expand my career in cosmetics in studying with plastic surgeons, I am able to look at smiles and faces in a new light and build them from a different perspective.  Dentistry is one of my passions and it’s an art form that I sincerely enjoy.

In what way do you feel Leonardo da Vinci has inspired or impacted today’s aesthetics both in dentistry and in facial plastic surgery?
Leonardo da Vinci studied the human body incredibly thoroughly; he made hundreds of drawings of dissections before we ever had cameras. He carried out dissections on approximately thirty corps and did hundreds of drawings which are still used as references today to understand the anatomy of the human body.  Combining  that knowledge of the internal structure of the human body, and being able to document that, measure body and facial proportions, and from there creating ideal norms has left a major impact on medicine today.

What are the principles Leonard da Vinci applied to his work and how do they apply to facial aesthetics as we know it today?
Leonardo’s references of facial norms, body proportions were absolutely landmark in the start of understanding how we look at the face and body. His principles were in his recording of observations of average and ideal norms of the face and body proportions, he created thousands of drawings of facial expressions, which is a reference for how we look at faces today. If we look at someone’s face and we see disharmony, we know what the norm should be for general facial aesthetics and the human body, which has given us a fantastic reference point of how to recreate or aesthetically improve someone’s face or body which is applicable to dentistry as well. We look at the teeth in a certain proportion and the entire face, because I want the smiles to be appropriate for the patient’s individual unique face.  Teeth have great variation and they are all elements of facial aesthetic and the body features that should work in harmony like an artistic composition.

Is accurate measurement important to facial dimension/harmony?
Accurate measurements are critical when I analyze facial dimensions. Utilizing artistic visualization skills and being able to evaluate symmetry, balance, and weight in an artistic sense are crucial, but you have to measure it. The utilization of today’s technology through computer digital and skeletal CT scans along with three dimensional models are essential in the design, treatment, and execution to create a predictable aesthetic result.  I create designs through the visualization of the problem and the solutions using photos, computer images and real models of the anticipated results. It’s an incredibly efficient system that I created for my practice, called the SOAP System, the System Of Aesthetic Predictability, or more affectionately known by my patients as, The Rifkin Method.  I created this system to ensure that no steps would be skipped and accurate measurements would be implemented, which are essential.

What is your favorite piece of Da Vinci?
I absolutely love one of his self-portraits, a simple line drawing of his face, and if you stare into his eyes and study his facial expression, you can see into his mind, and see how thoughtful, creative, and observant he was. He genuinely saw the world around us and was a wonderful observer of nature and promoted observation in order for us to truly absorb the impact of beauty.

How has your sculpting helped you with not just the understanding of the human face, but how it also helped you be a better dentist?
When you are performing dentistry or cosmetic surgery, you have to be aware of all the different structures. I couldn’t be the dentist I am today or feel that I am without this background knowledge. My early experience with sculpting enabled me to see more deeply into a structure. All day long in dentistry, I’m sculpting by shaping teeth and smiles; I’m forming lips, and looking at the entire face.  I build my sculptures from the inside out, I build the skeleton first, then I put on the muscles and I put on the skin. In the same way in dentistry and probably in plastic surgery, we should be looking at the skeletal system underneath. If a patient has a bad bite, we need to correct the skeletal system as well as the teeth which also have an impact on the facial structure and the smile. Sculpting is drawing in three dimensions,  drawing is the short hand of observation and design, and being able to draw is the quick study and sculpting is the creation of it building from the inside out delivering the most optimal final result that you can achieve.  I sculpt out of both passion and because it enables me to be a better dentist in helping my patients by being able to fully understanding the impact of what I do and create the best treatment plan.

How did Da Vinci’s influence your lip replica?
The lip replica is a 3-dimensional reference point for our laboratory technician or myself to either wax sculpt the teeth or create the ceramics, which is another technique that ensures facial and smile harmony. The lip replica was the first early reference in saying, how can anybody remotely create teeth in harmony with the face by just photographs; you really have to try them. Today I don’t necessarily do the lip replica, because I have my laboratory here, but between my photographs and computer design, I can create teeth that are in harmony by creating perfect Provisionals or temporary veneers. Then I duplicate that in the final ceramics, which helps decrease patient anxiety because there is excellent predictability of the outcome and we get to test drive the veneers before we actually make the ceramic ones by making beautiful temporaries.

As well as being a painter and a sculptor, Da Vinci was a also a technological innovator and conceptualized flying machines, armored machines, solar, adding machines to name a few. What’s your take on that, and are you able to incorporate any of that diversity into your approach with aesthetics.
Leonardo da Vinci, being the polymath genius that he was, was able to bring it all together, and in dentists and probably as cosmetic surgeons, we need to be mindful of the interaction and the interrelationship of everything. Da Vinci not only created beauty, but beauty to function. In dentistry we have to make things work, which is where Da Vinci had strong abilities, to look deeper into the total meaning of the beauty not only the symmetry, but the functionality. Cosmetics are a form of health by creating symmetry, balance, and proper function.  In dentistry, we have to be able to eat and speak with these restorations on our teeth. It is imperative that dentistry and cosmetics are built upon a foundation of health, function, predictability, and longevity.

To listen to Dr. Laurence Rifkin’s interview at Aesthetic Insider Radio, CLICK HERE!

READ MORE ABOUT DR. LAURENCE RIFKIN IN THE ARTICLES BELOW.

“Beverly Hills Cosmetic Dentist Shares Love of Art With Fellow Dentists At AMED”

“When Hollywood Smiles!”

To learn more about Dr. Rifkin, visit www.drlaurencerifkin.com and www.suite1200.com.

The post Leonardo da Vinci’s Effect On Today’s Facial Aesthetics appeared first on Aesthetic Insider.

In Hollywood, a smile is your greatest asset and world-renowned cosmetic dentist, Laurence Rikfin, DDS whose Beverly Hills practice sees an abundance of Hollywood stars on a daily basis, discusses with Aesthetic Insider Radio the secrets behind the brightest of smiles. Sometimes even the person with perfect teeth might need a little extra something to make them camera ready, while for others it may take cosmetic treatments such as veneers or other smile brightening procedures to make them picture perfect.  In this interview, Dr. Rifkin shares his secrets to keeping those pearly whites look as bright and fresh as possible, regardless of age. To learn more about Dr. Rifkin, visit www.drlaurencerifkin.com

What is it that draws us to a person with a great “Hollywood” smile?
I believe that there are great smiles and horrible Hollywood smiles. What draws us to a great smile, call it Hollywood or not, is the beauty and harmony with the face and the cleanliness of the mouth.  When you have a great smile, you want to smile more and you have a sense of friendliness and approachability which makes you more attractive. A great smile is bright, fresh, natural, healthy, and compels the owner to smile and show off their teeth. The smile has to fit your face, look like you, be undetectable, and appear as if they grew in your mouth and you were blessed with beautiful aesthetic teeth, lips, and gum tissue. We gravitate towards happy people that show off their teeth. Actors are constantly engaging with the audiences and fellow actors, which motivates us to focus on their mouth because it is a major communication tool for actors.  A great smile supports all of that. If it’s fresh, healthy, and natural looking that is the best Hollywood smile.

How can a person achieve a Hollywood smile?
A Hollywood smile is a natural smile. Developing a Hollywood smile begins when you are young. As a child, a parent should take their child to an orthodontist or pediatric dentist, to make sure that they are developing properly, straitening crooked teeth, and adequately maintaining the health of their teeth by brushing and flossing correctly, giving them a lifetime of a benefit of not only of health and function, but also a beautiful smile. If you are in the adult stage of your life, then smiles can be improved by analyzing the imperfections in the teeth themselves. For example, if the teeth are stained, we can do simple procedures such as teeth whitening. If their teeth are slightly chipped or crooked, we can do some minor orthodontics or direct bonding with some resin filling materials which can solve many minor blemishes. If you have more significant problems such as severely crooked teeth, than orthodontics is an option. If there is a combination of problems, we can address those with veneers and crowns; we do our best to be conservative and minimally invasive, and try to utilize porcelain which looks incredibly tooth like and natural when done properly. Achieving a beautiful smile begins early on in life and it should be continued and maintained throughout your lifetime.

If a person has good health, well maintained teeth and overall OK teeth, what else can be done to make their smile brighter and more charming?
There are several types of treatment that can help improve the smile.  The smile is not only the teeth, but also the gum tissue, the lips, and the surrounding skin. Gum tissue can be corrected if it is out of alignment. Additionally, Botox and fillers can absolutely change the shape of the frame around the teeth, in order to create better harmony that fits the facial features.

What were the specific needs of Scheana’s smile from Vander Pump Rules?
Scheana fractured a couple of teeth in her front part of her mouth and with the severity of the fracture and loss of teeth, we had to perform emergency care to create a beautiful looking smile during a longer term process which she actually lost one tooth.  The entire process took almost year, but during that time she always looked “picture perfect” even though she had some underlying treatment, to fix the front teeth and replace a missing tooth.

How popular are veneers and can you explain the process.
Veneers are one of the most amazing cosmetic treatments that has been innovated in dentistry; in the right artistic hands it can absolutely be transformative and create a beautiful natural smile. Veneers are cosmetically one of the best solutions for patients because they can solve a multitude of problems including: crooked teeth, teeth that are too narrow, gaps that need to be closed, and teeth that are too short or discolored. Veneers artistically should be built-in layers with different types of porcelain that appear natural and similar to a real tooth which has enamel and dentin.  The step by step process that I use to create this is first a photographic and three dimensional analysis of a smile.  We assess what our goals are and what the patient ultimately wishes. I then create models in wax and sculpt the teeth to the right dimension, shape, and form for that particular patient’s mouth. From the wax sculpture, we make perfect Provisionals, and we give them a test run in the patient’s mouth and cover the teeth. We analyze the shape of the design from the wax to the Provisionals acrylic which appears similar to real veneers, and if the patient is pleased with them, we duplicate it and improve them with the final ceramic restorations.

How popular is teeth whitening and how safe is it?
Teeth whitening is widely popular especially in-office because it creates a rapid improvement in the color of the tooth by eliminating the stain, it’s an extremely safe process. At home application could potentially be a problem for patients who are pregnant because a patient might swallow the bleaching gel and we are unsure of the effect it might have on the unborn child. The only negative potential side effect of teeth whitening is minor throbbing or temporary sensitivity in some patients for 24 to 48 hours following the procedure. Additionally, if you have active decay or broken teeth it is best to refrain from whitening those teeth until the teeth are corrected and protected from the bleaching gel. Other considerations that should be evaluated when considering teeth whitening is if you already have a filling, crown, or veneer in the front part of your mouth that would show, and if you bleach the surrounding teeth, the color of the porcelain or the bonding resin won’t whiten, which will result in a mismatch of color in the front part of the mouth.

Are there any simple things a person with good teeth can do to improve their smile?
One of the most foundational things that can keep the gum tissue healthy and the teeth less stained would be seeing your dentist and dental hygienist on a regular basis for a dental exam and cleaning, at minimum twice a year. Also, being diligent about at home brushing and flossing and making sure those oral hygiene techniques are up to par keep the bacteria away that causes decay, which is unattractive. Even slightly crooked teeth can be extremely attractive, just keep them fresh and healthy. We love to see people that are happy and smiling no matter what the condition of their teeth, smiling always makes you more attractive. It all comes from the inside out and the outside in, and my recommendations to improve a smile are to see your dentist and hygienist regularly and consider the minimal dental cosmetic enhancement treatments which can all truly transform the aesthetics of a smile.

To listen to Dr. Laurence Rifkin’s interview at Aesthetic Insider Radio, CLICK HERE!

READ MORE ABOUT DR. LAURENCE RIFKIN IN THE ARTICLES BELOW.

“Beverly Hills Cosmetic Dentist Shares Love of Art With Fellow Dentists At AMED”

“When Hollywood Smiles!”

To learn more about Dr. Rifkin, visit www.drlaurencerifkin.com and www.suite1200.com.

The post The Secrets Behind Hollywood’s Brightest Smiles appeared first on Aesthetic Insider.

Acne affects people of all ages and demographics and while there are many treatment options available many of them still leave patients with devastating acne scars. Steven F. Weiner, MD of Santa Rosa Beach, FL, has developed an approach to reduce and clear acne scars that has patients traveling from all over the world to smooth their skin and keep their complexions clear. In this interview with Aesthetic Insider Steven F. Weiner, MD, a Facial Plastic Surgeon and Head and Neck specialist who practices at The Aesthetic Clinique, discusses the use of new techniques and technologies that address acne scars in people of all ages and ethnicities. To learn more about Dr. Steven F. Weiner and his ReJAWvenation technique, visit www.theclinique.com.     

What is the most needed or popular technique you use to address acne scars?
We actually have four or five different techniques that we use to address acne scars and one of our more popular and effective approaches is called RF microneedling, which is radio frequency with microneedles.

How does RF Microneedling work?
The microneedles are insulated in a device where only the tips are exposed which causes an energy to be delivered beneath the skin into the dermis and into the scars. The body reacts to that coagulation and results in a remodeling of the scars and more controlled formation of collagen and elastin, as well as hyaluronic acid which greatly improves scars. The coated needles protect the upper skin layer from the energy/heat, thus improving safety for darker skin types and decreasing downtime and wound care.

Do you ever use laser for acne scars?
The problem with lasers is that they damage the surface of the skin often causing an inflammatory process that in the darker skin types such as Asian, Hispanic and African-American, that result in darker pigmentation. As many of my acne scar patients are darker skinned individuals the risk of hyper-pigmentation is significantly high so I prefer the RF microneedling which I feel provides an even better result than a traditional blade or laser would. However, in lighter skin individuals, laser can be used in conjunction with RF Microneedling.

How did you get started using RF Microneedling?
I am a constant learner and have a keen interest in new technology. Approximately six years ago a new technology came out from Lutronic who are a leading company in aesthetic medicine. I do a lot of work with Lutronic and was eager to do research on the initial device called INFINI because the technology was unique – deliver RF energy deeply into the dermis while bypassing the more superficial layers. More recently Lutronic came out with a newer version called the Genius which combines Radio Frequency Microneedling with impedance monitoring. This gives more precise energy delivery and safer treatments. The research results were reported in various media outlets and as I had been part of the intitial research team. The publicity generated more and more acne scar patients to my practice from all over the world.

Do you use other methods to help patients with acne scars?
Great question. Yes. Not everyone needs just the Genius, some patients need extra treatment. Going back to the basics, there are 4 different types of acne scarring. Atrophic, ice pick, boxcar, and hypertrophic scarring. RF Microneedling does treat all these scars, however, adding other techniques can help these patients get a really nice result.

Ice Pick Scarring: Can also be treated with a TCA cross which is a trichloroacetic acid application much like what is used in chemical peels. Using a toothpick application, the TCA is placed precisely in the middle of the scar (generally a very deep hole in the skin) which causes a chemical peel within the middle of the scar and, overtime, the body reacts by creating collagen so the depth and diameter of the scar decrease.

Atrophic Scarring: Those are more wide based and often associated with volume loss. Frequently there is a tethering effect of scar bands from the skin down to the subcutaneous fat, and even the deeper fat areas. Subcision is used to break the scar tissue from the deeper layers using a blunt cannula (which I also use for the fillers), or some doctors prefer to use a Nokor needle, which is a needle that has a small widened end, almost like a knife. However, a knife can cause injury to blood vessels and nerves, and bruising is often a side effect, therefore my patients have preferred the blunt cannula approach. At the same time, I can also inject filler to the patients that have volume loss and the type of filler use depends on what the patient desires. I will often use Restylane Defyne® or Restylane® Refyne. I may also use Bellafill® which is FDA approved for acne scarring and gives a great, long term result.

Boxcar Scars: These can be the most difficult to treat and frequently I will do a TCA Cross in addition to the Genius. It’s a very complex process and many of these patients will routinely undergo a laser treatment too. In addition, we can either use PRP (Platelet Rich Plasma), amniotic growth factors, or topical creams. Lastly, we use a Healite which is a low level laser light and LED light that soothes the skin, expedites healing and decreases the redness associated with the procedure.

Do you also help patients control acne breakouts?
Many of my patients have acne as well acne scarring and we have to treat the acne before we can begin an aggressive treatment for acne scars. At The Clinique we have a process to get the acne under control using almost exclusively lasers and topical skin therapy. We also use a vascular laser to offset the redness. In fact, we have three different lasers we use to control acne and the associate redness including the Excel V+ laser which is a 532 millisecond laser which attacks the acute acne and the pustules. We also use the Spectra by Lutronic, a 585 Q switch laser. This actually help improve the early acne scars and destroy the acne bacteria. We also use the Aerolase 1064 laser which is a micro second laser and is great for cystic acne, and the microsecond pulse duration is ideal and very well tolerated.

Do you see a change in any changes in a patient after your acne scar treatment?
Most patients are very happy as they thought they would have to live with that depth of scarring forever. One patient in particular will always stay in my mind. He was in high school and had been battling severe cystic acne for several years. He wore his hair over his eyes and he just couldn’t get excited about anything He couldn’t even look anyone straight in the eye because his acne and scarring was really terrible. I knew I could help but wasn’t sure just how much of the inflammation and scarring we could eradicate until we got acne under control. As mentioned previously, lasers, topicals and the Healight are something we begin to reduce the topical bacteria and acne proliferation. With this particular patient, once we were able to get his acne under control and soothe and heal the tissue, we were then able to work on the many acne scars that covered his face. What was amazing to me was watching this young man go from a being a silent and depressed recluse, to a smiling, confident and much more outgoing person. Knowing I can bring a new level of confidence and happiness to a person like this, touches my heart.

Dr. Steven F. Weiner can be reached at 850-622-1214. To learn more about acne scar treatment, ReJAWvenation and other aesthetic treatments offered by Dr. Weiner, www.theclinique.com

To listen to Dr. Weiner’s interview at Aesthetic Insider Radio, CLICK HERE

Other articles featuring Dr. Steven F. Weiner include: ReJAWvenation Techniques!

The post Acne Scar Breakthroughs! appeared first on Aesthetic Insider.

In this informative interview with Aesthetic Insider, Dr. Whitney Florin, a cosmetic surgeon who practices at Inland Cosmetic Surgery in Rancho Cucamonga, CA, discusses her expert approach to the most popular of all cosmetic surgeries — breast augmentation, reduction and lifting. If you want to learn how patients and their surgeons decide on the correct breast size, why there is a trend to smaller sized breast implants, or what different implant procedures and types of implants are available, Dr. Florin will discuss it all in this tell-all interview. Dr. Florin is a third generation physician who specializes in cosmetic surgery. To learn more about Dr. Florin and the aesthetic beauty and anti-aging procedures offered at Inland Cosmetic Surgery, call (909) 987-0899 or visit www.inlandcosmetic.com.

Questions You Always Wanted To Ask About Breast Surgery!

Why do you think cosmetic breast surgery ranks among the highest cosmetic surgery procedures?
For many women breasts can be a very defining feminine feature and the desire for women to have fuller or larger breasts, as well as those that simply want to improve the shape of their breasts, has grown tremendously. Also, the breasts are very commonly affected from pregnancy, breastfeeding, weight gain, weight loss, etc., and is an important body feature that often show the results of things women go through during motherhood, and other life changing experiences.

When is the right time for a person to decide to undergo cosmetic breast surgery?
We see young women that have not had any children but their whole life have desired larger breasts and it is something they’ve been thinking about for years. Those patients range in age from approximately twenty-two to twenty-five. We also see women that are coming to us after having children. In those situations, I recommend they wait about three to six months after they finish breastfeeding, but they generally come in to the practice sooner so they can obtain medical information and we can develop a plan and schedule a date for their surgery post breast feeding. For patients that have undergone a dramatic weight loss, I recommend the same amount of time – about six months after they’ve achieved their weight loss goal – in order for them to really have predictable results.

What are your recommendations to selecting the right surgeon?
There are many important factors when selecting which surgeon is the right one for you. From finding a surgeon who is well educated, and has substantial experience performing the procedure the patient is seeking, to making sure that the surgeon’s aesthetic is the same as the patients. Important questions to ask your surgeon are:

– What is their level of medical/surgical training?
– Where did they do their residency?
– Are they fellowship trained in cosmetic surgery of the breast?
– What length of time have they been in practice?
– How many successful breast surgery procedures have they performed?
– Are before-and-after photos available for review?
– Is it possible to meet with, or talk to, an actual breast surgery patient?
– What does the doctor recommend in terms of size, shape and type of implant? Is this what the patient had in mind?

In terms of breast augmentation, what does it entail, and what types of implants are available?
The two main distinctions are whether the implants are placed over or under the muscle. In our practice we almost always place implants under the muscle – that is called sub-muscular – and there are many benefits to this technique. In general, the implants have a better appearance and look more natural with fuller cleavage. The implant is also less obvious, and there is less chance of rippling or seeing the edge of the implant. Sub-muscular implants also tend to last longer and will deflate or rupture less frequently. We have also seen a lower rate of capsular contracture with the sub-muscular approach and the breasts generally remain soft and natural for a long time. Capsular contracture is a complication that can occur and causes hard tissue to form around the implant making the breast hard or painful. For that reason we almost always place implants under the muscle. There are two types of implants – saline or silicone. We discuss these options in great detail during consultation. We also discuss where to place the incision and how the implant is going to be placed which really depends on the person and their anatomy. The most common would be a small incision hidden under the fold of the breast, but an incision can be hidden around the ariola (the nipple), and saline implants can also be placed through a belly button incision which is a unique way to place an implant and we do offer that at Inland Cosmetics Surgery. Lastly, another incision option is hidden in the armpit on either side of the body.

How long does it take to recover from a cosmetic breast procedure?
Typically for breast augmentation I recommend that patients take about a week off of work and refrain from driving for one week. It is important that they do not do any heavy lifting for about three weeks after surgery which means nothing over thirty pounds and no strenuous exercise. After six weeks most patients can resume their normal activities including working out at the gym but they should check with their doctor before doing so.

Do you help a patient choose breast implant size?
Yes I do but breast size preference is very personal. Every day we hear phrases such as, ‘ I don’t want to be too big’ or ‘I don’t want to look too fake’ or ‘ I’m afraid I’m going to go too small’ so we assure our patients that the size they choose will be the right size for them. To help them with this decision we provide sizers that they can place inside a sports bra and we have them try on different sizes so that we can find out what they are comfortable with. This way they can go home and temporarily wear the different sizes to help them find the right fit. Our goal is to help a patient choose a size that matches with their silhouette and body size as most patients want their implants to look natural and proportional. Sometimes people do want an implant that exceeds their anatomy, and is going to go beyond their natural breast width or will stretch their skin too much. In those situations I advise them to select something smaller to begin as they can always choose a larger implant for another surgery, but it’s safer to begin with an implant that the body can handle. Other patients, generally athletic types such as marathon runners or weight lifters, want smaller implants that fill out their shape or give them a more feminine outline but nothing that is going to get in the way of their lifestyle.

Do you help patients requiring a breast lift or reduction?
Yes. We can perform a breast lift with or without implants. A breast lift patient generally has tissue that has streteched and lost some or most of its volume. If there is adequate volume we can perform a breast lift to reposition the breast tissue and areola (nipple) back to its original shape. If there is volume loss we may use an implant to replace the volume along with a breast lift procedure. In the case of a breast reduction, we generally perform this procedure on women struggling with large heavy breasts that may be causing shoulder pain, neck pain, back pain, etc., or are preventing them from running or high impact sports. Many of these patients just want smaller breasts and opt for a breast reduction procedure.

What tips would you offer to patients seeking a cosmetic breast procedure?
There are many things that can help a patient recover and heal and, of course, we are meticulous about suturing so that the patient not only recovers safely, but has optimal results. An important factor is adequate nutrition, I recommend all patients be on a multivitamin before their surgery and maintain a high protein diet after surgery. The other thing I recommend is sun avoidance, even one year after surgery incisions are still sensitive to the sun so I recommend a strong sunscreen applied directly on the incisions area as UVA rays can penetrate the fabric and make the incison marks darker. Another tip is that we recommend that most of the time a patient wear a supportive bra. Patients are going to have a very nice fullness and cleavage without wearing a bra, that’s the beauty of implants, however, the breasts will still sag with age so supporting them early on is always a good idea.

Why is suturing important?
Suturing is one of the most important aspects of any medical procedure and especially cosmetic ones. At our practice, we all use multiple layers of dissolvable sutures. That means they’re going to dissolve on their own. We do not need to remove sutures that have left tiny dots on the skin, or use staples that also leave marks on the skin. We use a system of meticulously placing multiple layers of dissolvable sutures so that there is a strong support system under the tissue so that when a patient moves the implant is held securely in place and the tissue can heal without distress. I feel that proper planning, careful marking of the patient before surgery, choosing an appropriate size implant for the patient, are all of the things that will maximize results and minimize scarring.

What changes have you seen in patients after breast surgery?
I love doing surgery but something that I love just as much is continuing to follow my patients after their surgery. We really get to know each other and people will share many stories with me. I see patients beaming from the inside out after surgery, they feel better about themselves, they begin to dress up more. Many women tell me that they feel sexy again, or sexy for the first time. Most of all the biggest change I see is that my patients exude confidence and are simply just happier with their life.

To learn more about Dr. Florin and Inland Cosmetic Surgery, call (909) 987-0899 or visit www.inlandcosmetic.com

To listen to Dr. Florin’s interview at Aesthetic Insider Radio, CLICK HERE

Other articles related to Inland Cosmetic Surgery:

Get Your Pre-Baby Body Back! – Dr. Irene Tower

Top Cosmetic Patient Procedures in 2020 – Dr. Jacob Haiavy

The post Questions You Always Wanted To Ask About Breast Surgery appeared first on Aesthetic Insider.