I am interested in getting a brow lift but there is one thing that is holding me back. I feel like I have a somewhat large forehead. It is not something that I feel like I need to fix, just something that I wouldn't want to get any larger. I am convinced that getting a brow lift would make this worse because I assume the hairline is raised. Is there some way to avoid this?
Yes. One way to avoid this is to do a temple brow lift which does surgery mostly on the lateral aspects of the brow. The other thing is to do what is called a tricophytic brow where the incision is just at the edge of the hairline and this will not increase the size of the forehead itself. Another procedure is simply to have hair transplantation done to the anterior aspect of the hairline to help bring down the hairline to the appropriate size that you wish. Any of those three things can be done as a way of managing the problem of an increasing forehead.
I am interested in plumping up my lips and like the idea of an injectable so that they are not permanent and I can try it out first. What fillers can be used in the lips and how long do the results last?
Generally, the two fillers that I like the best are Juvederm Ultra and Juvederm Ultra Plus, which can last anywhere from three to nine months depending upon the individual and are very safe. It also gives a nice look to the lips and if you want it to be temporary it will, as mentioned, be gone in somewhere between three and nine months and then can be re-injected to get the same previous effect. Also, some people use Radiesse which lasts a little longer in the lips. In my practice, I consider those the two best fillers to use in the lip.
I have a very broad jaw and being a woman it is something I have never liked. Recently I read that Botox can be used to weaken the jaw muscles to make it appear less broad. How effective is this?
Generally speaking, I would say that this is not a very effective procedure. Botox may give the jaw muscles some relaxation, however it is not a particular procedure that I recommend or encourage to my patients.
As I have gotten older my cheeks seem to be getting flatter. Is fat transfer a good solution for adding volume to the cheeks?
Yes, fat transfer is very good. In some people, however, the fat transfer is temporary and lasts in the area of three to six months. There are other individuals, though, who get fat transfer and get a much longer treatment response. Fat, if it is injected appropriately, will give nice filling out to the cheek areas. There are a number of other procedures, both in terms of fillers or implants, that may be a better solution for problems with volume in the cheeks which have to be determined by an actual visit. However, fat injections to the cheeks can be a very good procedure.
There seem to be quite a few different types of injectable fillers available. Which ones do you think are the most promising or most efficient and what are they best for treating?
There are a number of different filler available. I personally like the Juvederm brand of fillers: Bionicam which is Juvederm Ultra, Juvederm Ultra II and Juvederm regular. They last anywhere from 6 to 12 months depending upon the individual. They are not painful to place and they do an excellent job of treating the wrinkles in the nasolabial fold area, wrinkles around the corners of the mouth and wrinkles on the lips themselves. Perlane is another very good option and it lasts in the area of approximately nine months to a year and is excellent for the nasolabial fold area and for anything around the lips. Sculptra is a deeper filler that can be used to fill out more obvious or visible depressions in the face but occasionally has been associated with some granuloma formation.
There are also a number of other fillers available but I myself do not use them and cannot speak of having much experience with them. However, I find both Perlane and Juvederm to be excellent fillers with a very good response to the nasolabial folds, or corners of the mouth and lip areas. They also work very good in the glabellar forehead region.
I know that Botox and Dysport are good for treating forehead lines but are they good for treating anything else?
Botox and Dysport, which are a form of botulism toxin that paralyzes muscle tissue, are used for a number of other medical reasons besides just treating cosmetic reasons. They are also known for treating blepharospasm or twitching of certain muscles. They can sometimes be used to treat migraine headaches if a trigger point which may relate to muscle spasm can be found and they are sometimes used to treat torticollis and other problems in the neck.
One of the excellent side effects of Botox and Dysport beside treating the forehead lines themselves is that they also can relax the muscles and let the brows rise up, giving someone a better brow position and the benefits of a brow lift without actually having surgery in certain circumstances.
I had a nose job about a week ago. I know swelling is normal but it seems so extreme. My nose looks twice the size. I have to return to work soon. Is there anything at all that I can do to get the swelling to disappear faster?
First of all, swelling is normal after a nose job but if you feel it is extreme and there is a possibility that some other process may be going on like an infection, it would be to your benefit to show the situation to your physician. However, if it is just swelling related to the surgery, it should disappear significantly over the first three to four weeks and in total over a period of 9 to 12 months. The vast majority of people who have a rhinoplasty done look okay to go back to work within 10 to 14 days. Each case is different and some people, depending upon the thickness of their skin and the nature of their healing, may hold onto a more significant amount of swelling postoperatively than other people. The most important thing, as I mentioned before, is if there is any question of infection or some other problem to show it to the surgeon who did the actual rhinoplasty.
I have a very small receding chin and would like to get a chin implant. What are my options? What are the implants made of?
A small receding chin is an excellent situation for placing a small chin implant. This can be done under local anesthesia and it takes about a half hour. It is a very safe and easy procedure and, certainly for small receding chins, it is an excellent way to get a very rewarding effect where there is very little to be noticed in the way of surgery. The result is perfectly natural looking and permanent. The implants are made out of a soft silicone material which is inert and perfectly safe and has been used for over 30 years in this particular area.
Once again, a small receding chin is an excellent indication for a very small silicone chin implant that is placed into a small incision under the chin and disappears. It takes approximately 30 minutes and is an extremely safe procedure.
I am a 38-year-old female interested in a brow lift. I am a little scared of surgery and recently heard of something called a Botox brow lift. How effective is this and what exactly can it fix and how is it performed?
A Botox brow lift involves injections of the botulism toxin either by Botox, which is a product by the Allergan Company, or by a new product out now called Dysport. The injections will relax the muscles which will actually cause lifting of the eyebrows if placed in a proper position. In younger people who do not have a tremendous amount of brow ptosis, or sagging, it could be a very effective procedure and certainly is good in a sense that it does not involve a significant scar or surgery with anesthesia. Again, it is most beneficial for elevating the lateral and medial brows and can do enough in a person who has a minimal amount of ptosis to make a truly noticeable difference very safely. With Dysport, this would last approximately six to nine months. With Botox, this would last more in the area of two to four months.
I am 45 years old and have a horrible turkey neck. Is this something that a facelift would fix or is there something called a neck lift or some other procedure that just addresses the neck?
Yes, certainly a regular facelift would be a suitable fix for something that is described as a turkey neck. However, there is also a procedure which involves doing what we call a post auricular neck lift which can be done under local anesthesia and involves incisions just behind the ear and in the hair which can also take care of a neck problem. However, if there are significant problems with the muscles underneath the jaw area in the neck, there may be necessity for having an incision to specifically address these muscles. Also, if there is a significant amount of jowl laxity it may be necessary to come in front of the ear and do some pull in that area. But again, to answer your question, a facelift certainly takes care of a turkey neck but there is also something that is more specific called a post auricular neck lift which can sometimes also take care of the problem and can be done under local anesthesia and often in less than an hour.