Chin Implants
Chin Surgery
Chinplants
Chin surgery (mentoplasty) of a cosmetic nature is performed to reshape the chin by use of an implant or through chin reduction surgery on the bone. The nose and chin should be in proportion, and sometimes a surgeon may recommend chin surgery to a patient having rhinoplasty.

In the case of a chin implant, the incision may be made either inside the mouth along the lower lip, or under the chin.

Swelling will occur and should begin to subside over several days, but can sometimes take much longer. Strenuous activity must be avoided for several weeks to prevent injury to the affected area.

Collagen Injections
A young looking face is usually a full face. We've all heard the term "baby fat", and this applies to the face as well as the of the body! But as we age the fatty deposits under our skin tend to lessen, giving the face a more drawn and, therefore, older look. The development of wrinkles, unfortunately, accompanies this loss of facial fullness. Many find this to be especially true around the mouth area.

Some of the youthful fullness may be restored non-surgically with injectable fillers such as collagen. Collagen is a natural protein that supports the skin. Injectable collagen formulas derived from human dermis include Cosmoderm® or Cosmoplast®. Zyderm® and Zyplast® are forms of bovine collagen that, unlike human derived collagen, require prior allergy testing. The results may last 2 to 4 months.

Collagen injections can plump up thinning lips, fill out sunken contours, soften lines and wrinkles and even make some scars less noticeable.

Your expectations should remain reasonable when considering injectable fillers. This procedure cannot take the place of a facelift, but should soften the hollows and wrinkles which are the first signs of aging.

Collagen is a natural protein that supports the skin. Injectable collagen formulas derived from human dermis include Cosmoderm® or Cosmoplast®. Zyderm® and Zyplast® are forms of bovine collagen that, unlike human derived collagen, require prior allergy testing. The results may last 2 to 4 months.

The procedure is an outpatient procedures. See Injectable Fillers

Cosmoderm ®
Cosmoderm ® is a sterile injectable liquid made of highly purified human collagen, a natural protein that supports the skin. Cosmoderm ® is injected into the skin to correct soft tissue defects such as wrinkles and acne scars. CosmoDerm ® is used for minor skin defects and to correct soft tissue contour defects, such as wrinkles and acne scars

Please see our special page on Cosmoderm ®.

Dermal Fillers
Dermal fillers are injected below the surface of the skin. The use of dermal fillers is minimally invasive and is helpful in filling in wrinkles, creases, lines, and scars.

Dermal fillers are becoming increasingl popular as a first-step in retaining a more youthful face. These fillers plump up the skin, adding volume and fullness to specific areas of the face. These fillers are used mainly to plump up smile lines around the mouth and nose area and the fine lines which form above the upper lip. Fillers are helpful in reducing the severity of frown lines between the eyebrows. Dermail fillers also can be helpful in filling in recessed scars.
There are currently several dermal fillers on the market. Widely advertised are Juvederm ® and Restylane ® and Radiesse ®.

The cost of dermal fillers varies. The length of effectiveness varies, as well. Please remember that there are possible allergic reactions and side effects dermal fillers. These include, but are NOT limited to, infection at the site of injection; swelling; bleeding; bruising; redness; and, on occasion, more serious complications. Please do more research and ask you surgeon about the benefits AND risks of dermal fillers before undergoing the procedures.

We will have more information on dermal fillers in the coming months.

Dermabrasion

Dermabrasion is the mechanical scraping of the top layers of the skin. A high speed rotary wheel is used. The procedures softens sharp edges of surface irregularities, including acne and other scars and fine wrinkles, especially around the mouth.

Dermabrasion is usually done on an outpatient basis.

Ear Surgery - (Otoplasty)

Otoplasty, or ear pinning, is performed to set back prominent ears closer to the head. It is also used to reduce the size of large ears. Ear pinning is often done on children between the ages of 4 - 14 years of age. It is sometimes covered by insurance.

Otoplasty is usually an outpatient procedure.

Eyelid Surgery - (Blepharoplasty)

Blepharoplasty, commonly called eyelid surgery, is performed to correct drooping upper eyelids and puffy bags below the eyes. This end is achieved by removing excess fat, skin, and muscle.

The eyelid plastic surgery procedure is sometimes covered by insurance if it is used to correct visual field defects.

Eyelid surgery is usually performed as an outpatient procedure.

Eyelid Surgery page

Facelift - (Rhytidectomy)

Facelifts improve sagging facial skin, jowls, and loose neck skin. This is accomplished by removing excess fat, tightening muscles, redraping the skin.

Facelifts are usually outpatient, but some patients may require short inpatient stay.

Facial Implants

Facial implants such as cheek implants and chin implants, are performed to change the basic shape and balance of the face. This is accomplished by using carefully shaped implants to build up a receding chin, add prominence to cheekbones, or reshape the jawline with an implant.

Facial implants are usually performed on an outpatient basis, but there is occasionally an overnight hospital stay required.

Fat Grafting
The fat grafting procedure involves using the body's own excess fat (from areas such as the thighs or tummy) to fill out and contour the lips, cheeks or other parts of the body where augmentation may be needed to soften the body's contours. Fat grafting is also calle lipostructore, liposculpture and other similar names. The prefix "lipo" means "fat".

Fat grafting on the face can achieve a more youthful look. One of the main reason a face can look older is due to the loss of fat under the skin. Young faces are generally fuller and have more volume than mature faces. Not everyone is a candidate for fat grafting, so you will have to be honest with your plastic surgeon about whether you smoke, etc.

The excess fat removed from your body is treated before being implanted into the targeted areas, and there are different techniques for this implantation. Please discuss all your concerns about this procedure with your surgeon and, after surgery, you must carefully follow all post-operative instructions.

Fat Injections
As we age we tend to lose the "baby fat" under our skin resulting in less facial fullness. With the loss of fullness comes lines and wrinkles, hollows in our facial contours and an older look.

Injectable fillers from your own harvested fat (performed through liposuction of the thighs, stomach or other areas where excess fat is stored) can temporarily soften the facial coutours and fill in some of the lines and concave areas that are undesirable.
Human fat is taken from your own body and treated. The quality fat then can be reinjected to create facial fullness, fill in lines and folds and to build up shallow contours. Fat injection requires a more extensive procedure than other injectable fillers because it uses liposuction techniques to extract the fat prior to injection.

Injectable filler results may last up to a year and sometimes longer. Results are variable. Fat removed from your body can be stored for future use, but results is not as favorable as fat used at the same time it is harvested.

The cost of injectable fillers varies. The length of effectiveness varies, as well. Please remember that there are possible allergic reactions and side effects with injectable fillers. These include, but are NOT limited to, infection at the site of injection; swelling; bleeding; bruising; redness; and, on occasion, more serious complications.

Please do more research and ask you surgeon about the benefits AND risks of injectable fillers before undergoing the procedures.

Fibrel Injections
Fibrel is derived from a pig's collagen. Allergy testing prior to treatment with Fibrel is necessary. If swelling, redness, or firmness develope at the site of injection, the patient should not be treated with Fibrel.

Fibrel comes in a powerded form and mut be mixed with your own blood prior to injection. The procedure is complicated and involves more time than with some other injectable fillers because of the mixing with the patient's blood plasma. The blood must be removed from the patient first and the plasma mixed with the Fibrel. The opinion of many is that there is significantly more pain with this procedure than with some ohter injectables.

As with any procedure, there are possible side-effects. Please do more research and ask the surgeon questions before undergoing this treatment.

Forehead Lift
The purpose of a forehead lift, also called a brow lift, is to soften the expression lines, creases and other signs of aging in the forehead or eyebrow area. This cosmetic procedure also mitigates the frown lines between the eyebrows, and raises the eyebrows to give a younger appearance to the eye area.

The procedure may help to somewhat soften slightly hooded eyelids, although eyelid surgery is necessary for more obviously aged eyelids.

A forehead lift is usually done on an outpatient basis.

Hair Replacement Surgery

Hair replacement surgery involves the use of healthy, existing hair on a patient's scalp. A good candidate has healthy hair growth at the back or on the sides of the head. The hair from these areas is used as donor hair.

Hair replacement surgery is then done to fill in balding areas of the scalp by using a variety of techniques which include scalp reduction, tissue expansion, strip grafts, scalp flaps, or clusters of punch grafts (plugs, miniplugs and microplugs). Hair replacement works best on men with male pattern baldness after hair loss has stopped.

Transplant techniques, such as punch grafts, mini-grafts, micro-grafts, slit grafts, and strip grafts are generally performed on patients who desire a more modest change in hair fullness. Flaps, tissue-expansion and scalp-reduction are procedures that are usually more appropriate for patients who desire a more dramatic change.

It is important to realize that there are limits to what can be accomplished with hair transplant surgery and that you must have a generous amount of donor hair to achieve best results.

Hair replacement is usually done on an outpatient basis.

Hylaform ®
Hylaform ® gel is derived from avian (bird) proteins and is injected into wrinkles and facial folds to add volume to facial tissue. The effect lasts about 12 weeks.

Hylaform gel is sterile and colorless skin (dermal) filler made of chemically modified hylauronic acid derived from a bird (avian) source. Hylauronic acid is a naturally occurring substance found in cell and tissue fluids. It is chemically, physically, and biologically similar in the tissues of all species. Hylaform gel is made from purified, natural hylauronic acid that is gradually absorbed by the body.

Hylaform works by temporarily adding volume to facial tissue and restoring a smoother appearance to the face. The effect lasts for about 12 weeks. After the initial treatment, “touch-up” treatments may be needed to achieve optimal skin smoothing. Repeat treatments may be needed to maintain the smoothing effect.

Hylaform is injected by a doctor into areas of facial tissue where moderate to severe facial wrinkles and folds occur. The gel temporarily adds volume to the skin and can give the appearance of a smoother face.

Hylaform will help smooth moderate to severe facial wrinkles and folds for about 12 weeks. Some patients in a clinical study needed more than one injection to achieve a satisfactory result.

For more information on Hylaform ® , please visit our special information page: HYLAFORM (tm)

Injectable Fillers
As we age we tend to lose the "baby fat" under our skin resulting in less facial fullness. With the loss of fullness comes lines and wrinkles, hollows in our facial contours and an older look.

Injectable fillers can temporarily soften the facial coutours and fill in some of the lines and hollows. There are many different dermal fillers on the market today.

• Collagen
  Collagen is a natural protein that supports the skin. There are several injectable collagen fillers from humans which are currently on the market. Bovine collagen is also available, but requires allergy testing before use. derived from human dermis include Cosmoderm® or Cosmoplast®. Zyderm® and
• Hyaluronic Acid
  Hyaluronic acid is also a natural-occuring human subatance. Hyaluronic acid works will in plumping lips and in filling in facial lines such as the nose to mouth lines (nasolabial folds). The appearance of some recessed scars and other wrinkles may be softened with Hyaluronic acid injections.
• Hydroxylapatite
  Hydroxylapatite is a mineral-like compound found naturally in human bones, suspended in a gel-like formulation. It is the heaviest of facial fillers and is recommended to fill deeper creases such as nasolabial folds, marionette lines and frown lines, as well as to enhance fullness of the cheeks and other facial contours.
• Human fat
  Human fat is taken from your own body and treated. The quality fat then can be reinjected to create facial fullness, fill in lines and folds and to build up shallow contours. Fat injection requires a more extensive procedure than other injectable fillers because it uses liposuction techniques to extract the fat prior to injection.

Injectable filler results may last up to a year and sometimes longer. Results are variable. Fat removed from your body can be stored for future use, but results is not as favorable as fat used at the same time it is harvested.

Facial Fillers
There are numerous facial fillers currently available.
Check "injectable fillers" for more information.

Juvederm ®
Juvederm ® is a colorless hyaluronic acid gel that is injected into facial tissue to smooth wrinkles and folds, especially around the nose and mouth. Hyaluronic acid is a naturally occurring sugar found in the human body. The role of hyaluronic acid in the skin is to deliver nutrients, hydrate the skin by holding in water, and to act as a cushioning agent.

Juvederm ® temporarily adds volume to facial tissue and restores a smoother appearance to the face.

Juvederm ® is injected into areas of facial tissue where moderate to severe facial wrinkles and folds occur. Juvederm ® temporarily adds volume to the skin and may give the appearance of a smoother surface.

Juvederm ® will help to smooth moderate to severe facial wrinkles and folds. Most patients need one treatment to achieve optimal wrinkle smoothing, and the results last about six months.

For more information, including the possible side-effects, on Juvederm ®, please visit our special page: JUVEDERM ®.

Laser Facial Resurfacing - Laser Skin Resurfacing

Laser skin resurfacing involves the use of a laser (concentrated pulsating beams of light)to remove layers, one at a time, of irregular, damaged or aged skin. The procedure is used to reduce the appearance of wrinkles and fine lines, especially around the eyes, forehead and mouth. Laser skin resurfacing is commonly used to remove or lessen the appearance of facial scars or to even out unevenly pigmented skin. Sundamaged skin, age spots, warts, birthmarks and other skin irregularities may be helped by laser resurfcing.Cosmetic laser surgery of the face if usually performed on an outpatient basis unless combined with other cosmetic surgery which requires hospitalization.

Laser Hair Removal
Laser hair removal is the use of laser energy (single color or wavelength) to achieve long-term hair reduction. Heat from the laser is transferred to the hair follicle. which leads to inflammation and eventually the hair follicle goes dormant. You should understand that laser hair removal does not usually produce permanent results!

Side effects of laser hair removal, according the the FDA site, can include:

• blistering
• discoloration after treatment
• swelling
• redness
• scarring

Please visit our page on Cosmetic Laser Surgery for links to the latest FDA information on cosmetic laser surgery.

Liposuction - (Suction-Assisted Lipectomy)

Liposucton is performed to improve body shape by removing exercise-resistant fat deposits. A tube and vacuum device is used. Liposuction can also be performed by using the tumescent technique, in which targeted fat cells are infused with saline containing solution with a local anesthetic before liposuction to reduce post-operative bruising and swelling.

Liposuction is most commonly performed on the following areas: chin, cheeks, neck, upper arms, above breasts, abdomen, buttocks, hips, thighs, knees, calves, ankles.

Sometimes, for larger volumes of fat or for fibrous body areas, ultrasound-assisted lipoplasty (UAL) may be used. UAL is a new technique in which a ultrasound probe is inserted beneath the skin to "liquify" the fat before it is suctioned.

Liposuction is usually an outpatient procedure. Extensive procedures may require short inpatient stay.

Lower Body Lift

Often, after a large amount of weight has been lost, the skin will become loos and will sag. The lower body lift surgical procedure tightens the loose, sagging skin in the buttocks, posterior thighs, hips, outer thighs, and anterior thighs. The surgeon will make a series of strategic incisions - the incisions are made in areas where they will normally be hidding by clothes or lie within naturally occuring folds of skin - in the lower body (back, hips, thighs) and will then remove loose skin and underlying fat tissue. Post-operative swelling is common and is controlled by compression garments and the use of sterile "drains". Healing normally takes a month or even longer.

Lipo-Dissolve (lipodissolve)

According to the "Fact vs. Myth" section at www.fig.com, Lipo-Dissolve and mesotherapy are not interchangeable terms even tho they are often confused.

The information at www.fig.com states:
Lipodissolve is a procedure that uses standardized protocols for subcutaneous micro-injections with the sole purpose of dissolving fat.Mesotherapy injections are delivered into the hypodermis layer and can contain a combination of vitamins, minerals, amino acids and medications to treat a variety of medical conditions.,/i>

The Food and Drug Administration (FDA.gov) has not, as of this date, approved Lipo-Dissolve for fat loss. Please visit www.FDA.gov for the latest info.

Lip Augmentation

Lip augmentation is performed to create lips which are fuller and more plump and to reduce fine wrinkles around the patient's mouth. Either collagen or fat transferred from another part of the patient's body may be injected. The body will, over time absorb the injected collagen or fat so that this a treatment which must be repeated to maintain the desired results. Other injectables are being developed and used, as well, so consult with a plastic surgeon who specializes in lip augmentation to learn your options.

Male breast reduction - (Gynecomastia)

Gynecomastia is performed to reduce enlarged, female-like breast in men using liposuction and/or cutting out excess glandular tissue. This procedure is sometimes covered by medical insurance. (

Male breast reduction is usually an outpatient procedure.

Mesotherapy - Alternative to liposuction?

Mesotherapy, while pioneered in the 1950s by a French doctor, Dr. Michel Pistor, is a relatively new procedure in the U.S. Dr. Lionel Bisson (tm) is credited with having brought the procedure to the United States around that time, according to mesotherapy.com.
In mesotherapy, injections are made into the "mesoderm", or the layer of connective tissue and fat which lies under the skin. The injections may contain varying substances, including drugs and plant extracts. Lecithin, an emulsifier (emulsifiers help mix fats with liquids), is commonly used in these injections. Mesotherapy is used in body contouring of the jawline, waist, hips, etc., and is touted by some as an alternative to liposuction. But since mesotherapy has not been the subject of indepth clinical studies, there are concerns about its longterm effects and safety.

NOTE:We have not been able to find any information at the U.S. Food and Drug Administration web site on the keyword "mesotherapy".
http://www.fda.gov

Microdermabrasion

Microdermabrasion, as opposed to dermabrasion which can correct deep scars and wrinkles, removes ony a very fine layer of skin. But the gentle peeling can help remove fine lines, superficial scars, stretch marks, age and sunspots and it can also help with acne. Basically, microderm abrasion improves the overall complexion but also removes some mild imperfections.

Neo Strata

NeoStrata is a professional skin care system developed by some of the world's top skin care experts and is available exclusively through dermatologists and plastic surgeons. Utilizing an effective combination of alpha hydroxyacids, botanical and marine extracts, vitamins, antioxidants, and sunscreen, this advanced skin care system stimulates the regeneration of older skin, curbs the premature aging of skin, and improves acne, uneven pigmentation, and age spots.

Radiesse ®
According to the official web site:
Radiesse® is a safe, next generation dermal filler that does more than just fill in lines and wrinkles – it volumizes. In fact, Radiesse is setting a new standard in facial fold and wrinkle correction. This treatment restores a natural, youthful look that lasts. In many patients, the results may last for a year or more. Numerous medical studies have shown that Radiesse is a safe and effective treatment for filling and correcting smile lines, nasolabial folds, and wrinkles around the nose and mouth. Radiesse stimulates the body to produce new collagen. This unique response provides immediate, visible improvement of folds and wrinkles, and provides long-lasting and beautiful results.

Nose Surgery - Nose Reshaping (Rhinoplasty)

Rhinoplasty, or nose reshaping, is performed to reshape nose by reducing or increasing size, removing hump, changing shape of tip or bridge, narrowing span of nostrils, or changing angle between nose and upper lip.

If nose surgery is performed to relieve breathing problems, it may be covered by insurance.

Rhinoplasty is usually outpatient.