Tag Archives: sculptra

Non-Surgical Butt Augmentations with Sculptra

5 Jul

How To Get A Bigger Butt

Over the past 10 years the number of legitimate  butt implants has increased over 140% according to the American Society of Plastic Surgeons.  The number of fat grafting buttock lifts (Brazilian Butt Lift) is climbing at similar rate to implants.  Again, the Kardashian's influence over society.  

On the one hand, they really have opened the medical aesthetic market and probably saved it from collapse (there's an implant joke in here somewhere).  They do offer a lot of information to the public (although they manipulate the information they give so always remember–unless you are talking to an ACTUAL expert, information about plastic surgery, injectables, or skincare has no validity or reliability!)  They are however… idiots, for lack of a better word and are grossly miseducating the public on procedures. I'm not sure if I owe them royalties or not, but hopefully people who are planning on booking appointments in my office will have a better understanding of the procedures I offer.

There are 3 legal, safe, FDA-approved options to achieve that "Brazilian Butt Lift" (I mean BESIDES squats all day long).  


Butt Implants

Personally, I don't find this route to be the most aesthetically pleasing, and only know ONE person who has had a butt implant and been extremely happy and had no complications with this procedure (and this particular person does not have the most natural looking result, but they are happy with it!).  There can be extreme complications with putting a silicone implant in an area that is either in motion or bearing large amounts of weight (or both). Recovery is extreme and painful, and should there be a complication (this surgery has a very high infection rate) you're looking at up to 6 months out of work.   Even with a smooth procedure, long term complications such as the development of infection and shifting of the implant are possible.  

Surgical Butt Implants should be performed by a Board Certified Plastic Surgeon.  Implants can be different sizes, shapes, and put in different places to achieve the aesthetic outcome the patient is looking for.  Be sure to discuss your expectations for projection, size, and proportion to other areas of your body (like hips!).  




Fat Transfer

In order to transfer fat, you must HAVE fat to transfer.  Plan on needing to be 10-20 lbs over the appropriate weight for your body prior to transfer (your Board Certified Plastic Surgeon will tell you exactly what you need to weigh for the treatment). This is a hard concept for a lot of my clients to understand. You have to actually be able to grab the fat away from the vital organs that it protects. Skin is not fat. It can be just as hard for some people to gain weight as it is for others to loose it. If you have a hard time gaining weight, a fat transfer may be a waste of money for you.  

Immediately post transfer, expect a dramatic result, but do not expect that as the final result. Remember, not all the fat will graft, and there is a signfiant amount of swelling post transfer. It is important not to overfill the buttocks when doing a transfer, even though you might think you should to get more fat to graft. The increased pressure from overfilled, stretched skin may actually cause the fat to die. Recovery time is minimal, and you should follow any post-treatment instructions given to you by your plastic surgeon.  

I do think this is a great option (I personally do not do ANY surgical procedures in my office, but have seen MANY excellent fat transfers–I especially see great results for Brazilian Butt-Lifts in Miami! If this is something that interests you, I'm happy to pass along a great board-certified MD–the experience of the Dr. matters! Do not do this procedure with a general surgeon! 

Non-Surgical Options 

This is what I have to offer to the mix. I have been injecting Sculptra for it's intended FDA-approved use for about 8 years, and over the past 2 years, I've been doing TONS of it. I've always found it to be one of the best investments anyone can make in their skin, but it the hardest treatment to explain in terms of investment value. Sculptra is not immediate, it takes multiple vials, and multiple treatments which correlate to the amount of collagen loss the patient had to start, and what their expectations are. Although it is a commitment of time and money upfront, it is much more cost effective and natural looking than fillers. My mother has had sculptra treatments, and personally I would love to be injected with sculptra (I can't inject myself). If you are a yoga person or a runner, sculptra is FOR YOU!

Anyways, back to butts…

Sculptra Aesthetic is made with biocompatible, biodegradable, synthetic material called poly-L-lactic acid, which is gradually and naturally absorbed by the body and helps to rebuild lost collagen through a series of treatments. The specialist injects treatment within the deep dermis, where strands of collagen support your skin’s structure. For significant volume increase, a session of sculptra for the buttocks is 6-10vials, and 2-3 treatments 6-8weeks apart are required. The low-end cost for one treatment is about $6,000 and can be up to $12,000 PER TREATMENT.  


This procudure is certainly not affordable to the average person, BUT this product doesn't need to be done singularly. For patients who have previously had a fat transfer, and need more defined sculpting done in certain areas, this can be a great adjunct treatment.  If there is a small area of indentation, assymetry, or concavity that bothers you, sculptra might be a cost-effective option.  

Combination Therapy For Butt Augmentation 

Sculptra should be discussed with anyone who is planning on undergoing a fat transfer prior to thier surgical appointment. Just like any other aesthetic investment, managing expectations are vital, and although the expectations of the treatment are explained and discussed during Informed Consent, the patient should also have an idea of what follow up treatments they may require and their cost.  

As of publication of this post, these are the ONLY safe, FDA-approved (but still considered off-label) procedures you should even CONSIDER undergoing. Yes, all of these options are expensive, but if you cut costs and receive something other than these 3 options, there is a high chance you will have severe complications such as necrosis (tissue death), limb loss, or even ACTUAL death.  But first you'll pay up in hospital fees, because complications of elective, non-FDA approved procedures–insurance will not be covering those costs.  PLEASE do not put anything in your body that isn't safe!  

How to Get Rid of Cellulite

Guess what!  A variation of this procedure gets rid of cellulite.  Treatments for cellulite have traditionally been disappointing for the consumer, but this treatment is awesome!  Stay tuned for more blog posts on sculptra for cellulite reduction!  

with BlogPad Pro


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Peanut Head: Volume Loss at the Temples

29 Jul

I’d argue the most over looked sign of aging is loss of volume in the temple. As we age, the temples lose fat and begin to narrow, shifting the balance of the face downward. Volume loss here contributes to the appearance of drooping and sagging of the cheeks and eyes (see Structural Changes in the Aging Face for other changes).  It begins as early as in your 20’s. It is most notable in athletes who have very little fat on their bodies, I’ve found especially runners.

As you can see, the area of total volume loss is pretty big when you actually look at it. In order to achieve the youthful contour of the temple, a patient will require a lot of product here. Adding filler to the temple is easy and almost painless, but deciding what filler to use can be difficult, they all have pro’s and con’s.

Juvéderm

This is usually my first choice with patients. For some reason… people tend to be nervous about filling this area! The great thing about Juvéderm is that it’s disolvable. The bad thing about Juvéderm is… you need a lot of it to fill this area, and that can be expensive. I’ve found great results by diluting the product before injection. The patient can see the result immediately. It may not last as long this way, but it is a good starting point. Most people love the result and usually step up to Sculptra when they notice they need a “refill.”


Radiesse

I personally don’t use Radiesse in the temples. It always reminds me of the scene from the Real Housewives of Beverly Hills when Adrienne Malouff’s husband injects Taylor and she has this big bump in her temple and Adrienne goes “is it supposed to look like that?” Although you get more volume with Radiesse, you also have more of a chance for lumps in this area. It’s not as smooth as Juvéderm (which is literally defined as a smooth consistency gel). It’s just not my preference, but for extreme volume lost I can see it being more cost effective.


Sculptra

I personally have had Sculptra injected into my temples. Sculptra is not a filler, but a biostimulator. Over several weeks post injection it promotes collagen production. It may take more than one treatment (usually 1-3 vials 1-3 treatments) to achieve the desired result. This is the longest lasting, and most cost effective product if you consider the longevity, but up front can be expensive. If you are the type of patient who is doing multiple fillers at a time, you should probably step up to Sculptra.


Fat Transfer

Fat injections can also be used in the temples but are only cost effective if a large amount of volume is needed for the entire face. I recommend only allowing a plastic surgeon perform this procedure (although a nurse can do it in Massachusetts). The fat is harvested from another area of the body (usually the lower back) via liposuction and transferred to areas of volume loss in the face (usually not just the temple). There is a lot of swelling and bruising with this treatment and not all the fat will graft (stay alive after transfer). It is also an expensive and invasive procedure. This being said, it can yield great results for patients who really need it.


The Procedure

Numbing cream is applied to the temple. The product selected is mixed with lidocaine and deposited on the bone until achieving desired volume. There is very little pain associated with all injectable products. Bruising isn’t typical; however, there are many vessels in this area, so it can happen. Expected cost depends on the product selected, but expect to use at least 1-2 syringes during time of treatment.

Good luck!

Structural Changes in the Aging Face

3 Jan

Wrinkles and sun spots aren’t the only things we can expect to happen to our face as we age. There are many structural changes going on below the skins surface that contribute to an aging face that most people would never have noticed when they look in the mirror.

The young face on the left is round, contoured at the cheeks, and has a sharp jaw line (oh and hair and no wrinkles). The face on the right appears narrower, sunken, and droopy.

So besides the integrity of your skin, what else has changed?

Below the Skin

Bone Structure

Let’s start at the ground level. Your bones.

Your bones are always being built up and broken down. The rate at which the bone is broken down slowly starts to exceed the rate at which the bone is being built up as you age.

Bone changes cause:

  • a reduction in facial height
  • Increase in facial width and depth
  • The fat pad under the eye to bulge
  • A change in the shape and projection of the chin

Teeth

Injury and periodontal diseases result in loss of teeth, and it’s not like when you were young and the tooth fairy came and left you a dollar and a new tooth grew in (I hear with inflation it’s like $5 now!).

Loosing teeth affects the jaw bone and the muscles which attach to the jaw bone, which can result in make the face look narrower, hollow, and concave on profile.

Taking care of your teeth is super important, and not just for that pretty smile!

Fat Compartments

Collapsing fat compartments in the cheeks and temples reduce support to the overlying skin (side note: don’t worry! These fat cells go to other places… like your hips! j/k).

Splitting the face into thirds


Upper Third

Most people miss this when they look into the mirror at their aging face, but loss of fat in the temples results in the phenomenon I like to call “peanut head, ” which is also noticeable on super athletic people.

The presence of peanut head reflects a lack of support of the outer brow, which, along with loss of subcutaneous fat in the upper lid, causes the appearance of a droopy upper brow.

Blephroplasty anyone?  (Observing Surgery: Blepharoplasty.)

Middle Third

Eye sockets become wider and longer, resulting in a bulge of the cushiony fat pad that lies underneath the eye.

The cheeks start to flatten out, and the fat from the cheek descends to create a deep nasolabial fold.

The tear trough (area where eye skin and cheek skin meet) becomes noticeable. The middle third no longer has that fluid contour. This loss of fullness and form change causes shadowing in the trough, making a person appear to have dark circles, resulting in a tired appearance (just one of the things that causes dark circles).

Angles of the nose change, giving the appearance of increased length and the tip of the nose begins to droop.

Decrease of collagen and increase in tooth display at rest cause the upper lip to lengthen. Fun Fact: the upper lip can stretch by almost 4mm as you age.

(Stolen from another site…shhhh…) Image A shows a youthful face. Look at the contouring from the eye to the cheek. As you age, it can be convex like image B, which shows the fat pad bulging, or it can be concave like image C, making the eyes look hollow. Both B and C show a flat cheek when compared to Image A.

Lower Third

With all this stuff happening in the upper portions of the face, skin sags and starts to hang in the lower third. Adding insult to injury, the angle of the jaw changes, the jaw line, becomes less defined, and the chin shortens. Excess skin droops from the jaw line from gravity and loss of elasticity. Loss of ligament support in the jaw leads to the formation of jowls.

Even with droopy skin, the lower portion of the face starts to look smaller than the upper and middle third.

advancedskinwisdom.com a

(This image was also stolen).

What are your options?

Don’t worry. There are things you can do for volume loss! They do NOT include Oil of Olay, although the new commercial on tv claims it can (they lie).

Injections

For advanced volume loss, Sculptra is really the best injectable product. This product is a biostimulator; it works by stimulating your body’s own natural collagen. Results are the most natural of all the fillers, and the product lasts 2 years. I plan on writing a lot more about Sculptra, so stay tuned!

If you aren’t mentally or financially ready to jump into Sculptra, Radiesse is a wonderful thick, volumizing filler. It is usually my product of choice for cheek augmentation, naso-labial folds, and marionette lines.

For tear troughs, I LOVE Belotero (which is made by the same company as Radiesse). Filling this area literally takes ten years off your face, but remember, it is a very advanced procedure. Stick to a friend’s referral as to who to go to; I have seen a lot of over treated troughs!

For more help with fillers, check out What Goes Where?.

Surgical

Another option is fat transfer. I have assisted Dr. Russo in several fat transfers; it is a very interesting procedure. If you are planning on liposuction, I highly suggest inquiring about fat transfer as well.

For sagging skin around the neck and jaw line, surgery is the only real option to date.

XOXO, old LK

(I found the ‘Age My Face’ Ap… yes… there’s an ap for that!)

Things You Never Would Think To Find In A Girl’s Bathroom

6 Jul

How I’ve gone from your typical teenage girl to … an aesthetic specialist (for lack of a better term).

I remember when I moved into my first apartment in college, and I asked my mom for a make-up table, because there were 4 of us with one bathroom. I used to wear a lot of make-up. Case in point:

Summer of 2004. My candy raver phase? I guess. Over tweezed eyebrows. Check. Spots on my shoulder from too much tanning beds (which is actually caused from a fungus for all you spotted tanners out there… GROSS). Check. Face make-up too light. Check. Choice in jewelry… no comment. Oh. And I have roots. I think I might have been going to see Roger Waters with my college boyfriend. Man, college is a time for mistakes!

Hey, I also found my college bathroom circa 2004. (I am the original facebook generation… back when you needed a .edu to join).

UMASS. That should explain anything off you might see in this picture. But as you can see. Small space for four people. And a cat.

Anyways. Normal bathroom. Right? Also, I’d just like to point out that I used to eat nothing but candy. But I always brushed my teeth. As evidenced by me brushing my teeth

So I’ve gone from this:

To this:

Well… now fast forward 8 years. I wear very basic make-up that takes me literally five minutes to do, but in return I have the weirdest stuff in my bathroom repertoire! Used for purposes I’m sure very few could guess! So here’s an insiders sneak peak to my bathroom. I hope you find this as ridiculous (and funny) as I do. Welcome to the bathroom of a high maintenance princess.

Shot 1:

I took this pic a few months ago and sent this to one of my co-workers. I thought it was absolutely comical that I had this stuff on my bathroom sink counter.

I believe the tweezers were for applying fake eyelashes. I learned to stop tweezing my own eyebrows. Please refer back to the college years if you are curious as to why.

I suppose pliers wouldn’t be a strange thing to have in the bathroom. I’m not sure what you would actually use them for or how to actually spell that word… but I use them to take out my hair extensions if they’ve gotten a little loose. Not normal.

Revitalash I use to grow my eyelashes longer and stronger for lash extensions… and because sometimes I ruin my lashes with the strip adhesives. Gotta have lovely lashes.

Shot 2:

My make-up bag. Fake Eyelashes. Behind that… Fake hair aka Diva Weava.  I wouldn’t be a Barbie Doll if I didn’t have Fake hair.  And my fav hair tool: my pink GHD

That is a legitimate paintbrush in the middle there.

Shot 3.

Shot 4: Stuff that is Usually on My Bathroom Counter

  1. Baby Powder: for my roots because I only wash my hair twice a week.
  2. Dry Shampoo: because sometimes baby powder isn’t my scene.
  3. QuickTan: Because sometimes you have to go from white to orange in 20 minutes or less.

What I’ve Done.

And then I also did a quick draw a few months ago (back when I was blonde) on all the stuff on my face that was changed. It was kind of shocking to me. I wasn’t going to post it… because there are always people out there that like to tear you down. But I guess I’m somewhat amused by it. And comfortable enough to say, bring on the controversy.

            

  1. Botox in my Glabella and Forehead
  2. Lip Augmentation  Pucker-Up, Princess – Damn Sexy Lips.
  3. Sculptra to my temples
  4. Cheek Augmentation
  5. Eyeliner tattoo
  6. Eyelash extensions
    Lovely Lashes!.
  7. Hair extensions
  8. I have juvederm under my eyes as well.

No Surgery Needed!

“Plastic surgery and breast implants are fine for people who want that,

if it makes them feel better about who they are. But, it makes these people,

actors especially, fantasy figures for a fantasy world.

Acting is about being real being honest.”
Kate Winslet

Dear Kate Winslet,

I appreciate your support for people to make their own choices on

Plastic Surgery. I assure you, I feel great about myself.

More confident than Superman. Oh wait. Is he real?

Or is that part of my delusional fantasy world?

Is that sarcasm? Or real honesty?

XOXO

LK

Like my Patriotic Red Extensions from July 4th? Happy Birthday America!

Thank you for giving me the freedom to be delusional and honest.

Under Eye Circles and Bags

16 May

Physiology: Broken blood vessels within the lower eyelid. A shadow forms underneath the bag causing the dark circles to appear. As you age, the “bags” (fat pads) can bulge due to gravity, creating an exaggerated space between the skin of the check, and the skin of the eye, over the orbital rim (bone of the eye socket). These dark circles can bring about a chronically fatigued look, or make you appear older than you actually are.

Cause: range from fatigue, vitamin deficiency, hyperpigmentation, allergies, age, and medical conditions. However, heredity is the most common cause for bags under the eye (also, from my patient’s personal experience… I hear children and husbands may also be contributors? It has not been clinically proven however.).

Treatment:

Getting the proper rest and eating the right foods can sometimes help treat and improve dark under eye circles, but if genetic, dark under eye circle will increase if untreated.

Fraxel®, Thermage®, Blue Light Therapy, IPL Photofacial, Dermal Fillers and Chemical Peels (like TCA). Patients with more severe cases of under eye circles, puffiness and loose upper or lower eyelids may want to seek out surgical alternatives including blepheroplasty.

My Best Advice

It is always a good idea to start with the least invasive methods and move on to the most invasive methods. That being said, genetics does play a HUGE role in this, and if your mom or dad has extremely sagging lids, or bulging fat pads, the earlier you do surgery the best result you will have. I’ve done multiple surgeries with Dr. Russo. He does an amazing job, and it’s definitely one of my favorites to assist in!!!

Least Invasive to Most Invasive

  1. Hydration: The area of skin under the eye is the thinnest in the body. In a hospital setting, we monitor this area as a sign that a patient could be dehydrated. I can always tell when someone needs fluids just by looking at this clinical sign. Start with drinking water… water is good for your body all around. And… it’s FREE!
  2. Eye Cream: Supply your skin with the nutrients it needs. By depositing certain vitamins and peptides, you can decrease the appearance of dark circles. Before you tell me you’ve tried every cream under the sun… have you read my post on pharmaceutical products? Step 2: Spend wisely.
  3. Noninvasive treatments: Laser stuff. Not my area of expertise, however, I have had IPL on melasma, and it worked great. Laser treatments will help with the discoloration, and may subtly tighten the skin, but they will not fill volume loss. If you have volume loss, see step 5.
  4. Chemical Peels:  Best done in the winter time when you’re not in the sun.  And actually… this is more for fine lines and wrinkles around the eyes than bags and dark circles.  Although it will help the appearance.
  5. Dermal Fillers : (That’s NOT Botox..) A hyaluronic acid of low molecular cross linking like Juvéderm Ultra is most recommended for this area. Thicker fillers, like Radiesse, and biostimulators, like Sculptra, are not recommended for this area. Remember this skin is the thinnest in your body, and thicker products can leave bumps here. Be VERY careful about who you see for this treatment. It is a very advanced procedure that your Dentist or Primary Care probably shouldn’t be performing on you.
  6. Blepheroplasty: Check out my post on Blephs. Observing Surgery: Blepharoplasty.

Dermal Fillers

Dermal Fillers are my area of expertise (Remember photography is also not my thing!!!)

Here’s my Before and After Tear Troughs:


Before: I look tired. And old. Ew. Taken November 2011.


After: As you can see I look more awake and refreshed. Taken February 2011 after I had my tear troughs filled.

I am very happy I did this. Surprisingly, it didn’t hurt at all. The product used was Juvéderm Ultra. It will last about a year. Cost is about $600.

Creams

(The two I like best)

Image Max Eye Cream: This next-generation revolutionary day and night eye crème contains high concentrations of growth-factors derived from plant stem cells to protect skin cells and prevent aging effects caused by free radical damage. Reduces the appearance of fine lines and wrinkles; reduces puffiness and inflammation. Prevents cell aging. Contains grape, alpine edelweiss and apple stem cells for maximum age prevention. Corrective peptide blend for rejuvenation. Retails for about $45

Image Vital C: A scientifically- advanced hydrating, anti-aging eye gel. Contains a blend of nourishing anti-oxidants that reduce the appearance of fine lines and prevent the breakdown of collagen. Vitamin K  (Phytonadion) diminishes dark circles. Restores youthful looking eyes. Retails $31


A Bride’s Guide

17 Mar


Every bride wants to look perfect on her special day, and that takes a lot of hard work and preparation (or so I hear…)… I thought I’d be a big help for all those brides (and their bridal parties!) with a little bit of information you might find helpful!

Actually… I think any time anyone attends a wedding they want to look good. Weddings = Pictures. And now-a-days, pictures – the good, the bad, and the ugly – wind up on Facebook! So if you’re at the age where you will be attending lots of weddings in the near future (i.e. my age) you might want to take some notes…

Non-Invasive

Spray Tan

Spray tan’s typically last 7-14 days.  If your thinking of spraying (which I highly recommend), do it as close to your big day as possible!  You can’t shower for 6 hours after a spray, and you can smell a little bit sugary post-spray, so keep this in mind.  For the best results, spray the day before. As it wears off, it can sometimes look a little patchy. Make sure you exfoliate prior to your appointment (and shave).

Also, I hear there is a new spray out, that has glitter in it (OMG RIGHT!), but it’s only good for 24 hours I think? Maybe someone else knows more about this? I would also like to note here, that if you are not the bride, you should NOT be shining. That’s rude.


Facial

A plain old facial can be done anywhere from a few days to a month before a special date. Healthy skin is essential for a beautiful face. I recommend everyone see an aesthetician and purchasing some products that will keep your skin healthy.

Weddings are super stressful, and your skin responds to stress. Facials will keep break-outs at bay, not only by cleaning your skin, but by giving you some quality relaxation time. Spa days are great to do with your friends, mother, and future mother in law!


*Note: if you are planning on doing Botox or fillers, a facial should be done either immediately before or 5 days after any facial treatments.

Chemical Peel

Degree of peeling can vary, so talk to the aesthetician performing your peel and be CLEAR if you have any wedding events (or any events for that matter) that you don’t want to be shedding for. ‘Tis the Season for Chemical Peels!.  For a real good, deep peel, expect about a week to two of down time. Trust me, it’s worth it.

Very Important:  moisturize often with a pharmaceutical or cosmeceutical grade product after a peel.  Many places have post-treatment kits.  Do NOT pick at your skin!  Stay out of the sun! Do not use Retin-A prior to or post treatment for about 7 days.

Waxing

Waxing your brows or lip shouldn’t be done the day of an event.  The process can irritate your skin, leaving it a little red.  Icing the area helps.  Or an anti-inflammatory like ibuprofen.  Make sure to keep the area clean to keep bacteria out of your pores, and causing break outs.

Microdermabrasion.

Often done during the same time as a facial, and can cause some minor redness.  Protect your skin after this treatment. Again, stay out of the sun, and do not use Retin-A prior to or post treatment for 7 days.

Laser Skin Rejuvenation Treatments

Depending on the laser, and the treatment, there can be some downtime with this (discoloration and flaking), anywhere from a day to a week.  Ask your practitioner what to expect with the treatment you are receiving.  These treatments really make your skin look great!  Never heard of laser skin rejuvenation?  There will be blog posts to come!

Teeth Whitening

It depends on the number of treatments you will need to decide when you should start. Some treatments take a few sessions, some are one and done. Go for a consult. At the very least, do the Crest White Strips.

Long Lashes

A lot of brides ask me about eye-lash extensions. Although a little expensive, they look great for a wedding.  They should be done about a week before your big event.  They take some getting used to! Lovely Lashes!. They also don’t last very long… usually about a month, so don’t do them too soon unless you are going to keep up on them. If you are having your make-up professionally done, the make-up artist will probably offer you some sort of fake-eyelash. If you are doing your own make-up and you want that lashed out look, practice a few times before the big day. I am a master of the strip lash… but it took me about a year to perfect my technique!

Minimally Invasive Procedures

These can be tricky to time.  If you are planning on doing any non-invasive procedures, they should be done either immediately before Botox and Fillers, or 5 days after.  This is because you don’t want Botox to travel into the wrong muscle group, or fillers to be moved into the wrong area.  Use good judgment with timing your treatments!

A lot of women do Botox and fillers before a big wedding!

Check out this article: http://www.nytimes.com/2008/07/24/fashion/24skin.html?pagewanted=all


(I’m the bridesmaid all the way to the left. I would like to add a disclaimer: The bride here is naturally beautiful. And has not let me tempt her into Botox—yet).

Botox

If you are new to Botox, I suggest trying it out 4-6 months prior to the wedding date for a couple of reasons. First, this way you can decide if you like it (which you will, but I still recommend trying it). Second, Botox is a dose dependant medication (your results depend on how large or small a dose you receive). Six months gives you plenty of time to work out with your injector the perfect dose for you! Last, you will not be able to look angry for 3-6 months. This might be helpful to any Bridezilla’s out there. So, when you are in witch mode, at least you won’t look like it. J

If you don’t have six months to do a trial run, if you are a Botox Pro, or if you just want to go for it, you should have your treatment AT LEAST 1 month prior to the big day, and NO MORE than 2 months prior. Anything more than 2 months, it might start wearing off, anything less than a month you might not have the result you desire.

Another interesting use of Botox with Brides: It is becoming popular to be treated for hyperhydrosis (sweating) in the underarm. I recommend this to brides who will be getting married outside in 100 degree weather. Sweating profusely is pretty gross. You’re already going to be nervous, and when you add your layers of dress (which I’m sure is not air conditioned), and all the dancing you’re going to do… might be a good idea. Plus, you didn’t spend all that money on a dress to have pit-stains on it. This procedure requires a pretty big dose of Botox, and is therefore pretty expensive. It’s not for every bride.


(Remember don’t go overboard either!)

Fillers (Radiesse, Juvéderm… Perlene, Restyline, ect. ect.)

Depending on the area of injection, there can be some minor bruising (or major depending on the injector).  Invest in some Arnica cream, and expect the worst (2 weeks).  Cheek augmentation bruises the least, while lip augmentation and nasal labial folds tend to bruise the most.  Gosh, I hate it when I have dental work 😉 The average bruise lasts a few days.

Usually older brides are doing facial fillers, while younger brides might want to plump their lips.

As for the rest of the wedding participants, the mothers of the bride and groom are usually also very interested in fillers (and Botox). After all, they have been looking forward to this day since the days BEFORE their children gave them premature wrinkles. Whether she is interested in a facial or Botox treatment, moms deserve to be asked “is this your sister?”

Things to Do 6 Months or More before a Wedding (or wait until after):

–  Bioenhancers like Sculptra Aesthetic (it can take up to 6 weeks to see a difference)

–  Plastic Surgery. Remember that crazy reality show on TV that brides were competing with each other trying to win plastic surgery procedures so they could be perfect for their big day? Those women were … appalling. Plastic surgery should never be taken lightly. Or have a competitive reality show. Leave competitive reality to “Survivor!”

–  Changing your hair color or cutting it short (stick to what you know looks good on you!)

That’s NOT Botox.

18 Nov
Another strong misunderstanding a lot of people have around the Boston Area is what products go where Botox does not.   If it’s caused by gravity:  THAT’S NOT BOTOX!

HYALURONIC ACID (HA) FILLERS (TEMPORARY)

Hyaluronic acid fillers are synthetic sugars that attract water molecules.  They are placed in actual wrinkles or other areas that need volume and offer instant results. They fill in marionette lines, lift up jowls or plump up volume along the jaw line where definition has been lost.

Restylane, Perlane and Juvéderm (www.juvederm.com) are the most commonly used hyaluronic acid fillers, with Juvéderm being the leading product (I refer to Restylane as ‘old school’).  There is no need for allergy testing, as these products are sugars your body naturally makes.  There is little pain with injection, as the new products come with lidocaine added as a powder to the product.   Expect a topical numbing agent (topical lidocaine) to be applied prior to injection.  This should be left on for AT LEAST 20 minutes.  The actual procedure only takes about 15 minutes.  Swelling and bruising are possible and you should probably not do a filler if you have an important event within a week from treatment.  ICE ICE ICE!  I also recommend arnica montana cream which can be purchased at GNC or Whole Foods.  You can expect results to last from six months to a year, depending on the brand and where it is placed (Juvéderm lasts the longest).

I have Juvéderm filler in my lips.  It feels and looks natural.  It was the first injectable I tried, and I’m very happy with it.  😉  I mostly just use HA’s in the lips and very deep frown lines between the brows.  Reason being, HA’s are injected into the superficial dermis and do not give as good of a fill for the cost for deep lines and folds.  I like other products more for those very deep lines.

Calcium Hydroxylapitate (SEMI-PERMANENT)

Radiesse (www.radiesse.com) is an example of a semi-permanent filler and it is made from calcium molecules suspended in a gel which stimulates your collagen. The microspheres in it create “scaffolding” that your own collagen will grow around, but is eventually broken down by the body. Radiesse can be used to fill the nasolabial folds and marionette lines, as well as define the contours of the face.  It goes deep in the dermal layer of skin, and should NEVER go in the lips!

Lidocaine topical should be applied 20 minutes prior to injection.  Lidocaine is added to the product immediately prior to injection.

I recently had a little lift put in my cheeks (as described in a prior blog).  I had zero pain or discomfort.  The lidocaine eventually traveled down my nerve from my cheek to my lips.  It felt a little funny!  It looks and feels completely natural. 

COLLAGEN STIMULATORS (aka collagen builders or stimulating fillers)

Collagen stimulators contain particles that signal the skin to produce more collagen. Instead of just filling in select lines and wrinkles, these are used on larger areas like the cheeks.  They can be used in areas where synthetic fillers look somewhat unnatural (like the lower face under the cheek area).  Results are not immediate; it takes about 6 weeks to see the result of the collagen stimulation; however, the product lasts two years.  Most women prefer the gradual change in their facial contour.

Sculptra (www.sculptraaesthetic.com) is an example of a collagen stimulator. It is approved by the FDA for restoration and/or correction of the signs of facial fat loss (lipoatrophy) in people with human immunodeficiency virus (as is Radiesse). Most patients require an average of two to three treatments six weeks apart for optimal results.

I had Sculptra injected into my temples.  Zero pain.  My patients are in LOVE with this product.  It costs about as much as other fillers when you take into consideration how long it lasts.  It also looks COMPLETELY natural due to the fact it’s ALL your own collagen produced.  I foresee this product being my number one injectable within the next year!  Move over Botox!!! 

COLLAGEN FILLERS

Although collagen fillers changed the face of beauty when they entered the marketplace in the 1980s, they quickly fell out of favor when longer-lasting hyaluronic acid was introduced. However, many doctors still use collagen, especially for plumping the lips and filling in “smoker’s lines” around the mouth.  Although overfilling is necessary to achieve the desired result, the excess fluid is absorbed over the first few hours after treatment, and minor redness and swelling subside in a few days.  Results last from two to three months… also known as a waste of money when there are so many better products!

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