When You Look Marvelous… Millennials, Botox, and Natural Beauty

Billy Crystal’s Saturday Night Live character Fernando said things like, “When you look marvelous, you feel marvelous” and “Remember, it’s better to look good than feel good!” Well he may not have been too far off.

billy crystall mahvalousRecent studies have studied the effect of the neuromodulators Botox®, Dysport®, and Xeomin® on depression. The studies have shown that Botox® may be as effective for the treatment of depression as anti-depressants. The reason for this is thought to be the synaptic axon connections between facial muscles and part of the brain that senses expressions on the face caused by these muscles. Our brains can sense the expression on our face. When we look sad, tense, or angry, the facial muscles are contracted, the brain senses this and we feel sad, tense, or angry. There is a feedback loop that reinforces mood. The brain can also sense when the face looks relaxed, calm, and happy. Botox® relaxes the muscles that create angry, stressed faces, therefore the patient cannot make the angry unhappy face, quite the opposite results, a rested, calm, happy face. The majority of Botox® patients report “feeling really good” a few days after their Botox® injections. Many facial plastic surgeons believe that we may be treating depression with Botox® within the next 5 years.

There has been a large increase in the number of millennials who are requesting facial aesthetic treatments. The rapid rise of “Selfies” and the effect of the Kardashians have led to a rise in patients 30 years old and younger seeking facial aesthetic treatment. The most popular millennial requests are for lips, cheek and facial volume enhancement, fine line treatment and prevention, and skin care.

INJECTABLE COMBOThe treatment of young patients demands a most conservative and natural approach. Patients wish to look like themselves only better. All patients should be extremely careful in choosing their aesthetic physician based on their skill, experience, care, and most importantly natural artistic vision!

Minimal amounts of Restylane Silk® and Juvéderm Ultra Plus® are used to create soft, full, natural, sexy lips in younger patients. A little more can always be added if needed, but lips that are too large, out of proportion, or shaped like a Lip Augduck’s bill are to be avoided at all cost.

Faces begin to lose bone volume from age 25 on resulting in early facial sagging. Hollows under the eyes, diagonal cheek valleys, nasolabial folds all immediately improve with properly placed Juvederm Voluma® and/or Sculptra®.
Dr. Michael Persky is on the advisory board and a clinical injector trainer for Sculptra®, and has injected more Voluma® than any other practice in The Valley.

Botox® used in miniscule doses on younger faces gives a more rested look, tightening the forehead, and diminishing lines around the eyes. Some believe that early Botox® treatment minimizes facial rhytids (lines) later in life.

Millennials love Clear + Brilliant™ to brighten their skin. Our licensed esthetician, Samantha Potter, customizes each patient skin care regimen recommending the most effective scientifically proven skin care products selected and tested by our physicians. We offer oxygen infusion facials, peels, micro-needling with or without platelet rich plasma, micro-dermabrasion as well as advice on healthy living.

Dr. Persky and Dr. Sunder love to answer questions about all aspects of facial plastic surgery. Please feel free to contact us at your convenience. As Fernando says, “Remember, when you look marvelous you feel marvelous.” Be well.

Call the office at 818-501-FACE to schedule your complimentary facial analysis.
Bookings@DrPersky.com

The Four Most Popular Men’s Facial Aesthetic Treatments

Men deserve to look good too!

We are often asked, “Doc, what percent of your patients are men?”  Historically, about 10-15% of our facial aesthetic patients have been men.  With recent non-invasive, non-surgical treatments that are quick, easy, safe, effective, and require no downtime or much follow up, more men are seeking facial cosmetic treatments.

The American Society for Aesthetic Plastic Surgery revealed that “men are turning to aesthetic cosmetic procedures, with dramatic increases seen in both surgical and nonsurgical options over the past 5 years, 43 percent increase overall.”  Many men are still hesitant to be treated.  This prompted us to wonder, “How is it that men are still shy about facial aesthetic treatments? It couldn’t be just about being embarrassed for wanting a smooth forehead, lifted eyelids, excellent skin tone, or a chiseled face? Could it? Well yes, not only they are embarrassed but they also don’t necessarily have the support they need to get what they want. Many men do not know what treatments are available to them! There are so many misconceptions out there.  The comments that we hear most from hesitant men are “Cosmetic procedures are for women”, “I want to look like myself”, and “I don’t want my face to be feminized.”  This is where the expertise of Michael Persky, MD and Sarmela Sunder, MD comes to the rescue. It takes knowledge, experience, talent, technical skill, and most importantly a natural artistic vision sense to achieve natural beauty enhancement in both men and women. There are differences in the male/female aesthetic. While most women strive to look younger, most men wish to look rich and powerful. Drs. Persky and Sunder appreciate the subtle different aesthetics in the treatment of men versus women.

Women LOVE a man who takes care of himself, beyond the shower and occasional cologne. A man who takes pride in his appearance is not vain, rather the man who takes pride in his appearance displays a certain respect for himself, looking his natural best. We listen to our patients aesthetic requests and help them achieve their goals in a natural, “non-plastic surgery done look” way. Our patients tell us over and over again, “I am very pleased with my treatment, I look like myself, only better!”

The four most popular procedures that give men the “ biggest bang for their buck”are Botox®, Voluma, Ultherapy (non-invasive lifting of the face, neck and brows), and blepharoplasty (eyelid lift). Those particular procedures can give any man the boost of self-confidence and facial rejuvenation without compromising their masculinity or manhood.   You can trust you face to these two board certified facial plastic surgeons. Feel free to contact us with any questions that you may have regarding facial aesthetics. Be well.

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The Natural Beauty of Renaissance Angels Available Today

rena Crowning of Mary Pinacoteca Vaticana, Raffael, Angel

Simplicity is the ultimate sophistication.
– Leonardo da Vinci

Artists of the Renaissance were well aware of the natural beauty of the face.  We see this beauty in their works of art.  In my current practice of facial aesthetics, study of the natural beauty of Renaissance angel faces painted 500 years ago serves as a guideline for creating beautiful faces in my clinic today.  Leonardo da Vinci defined the “Devine Ratio” of beauty in the 1400’s.  Leonardo appreciated naturally occuring proportions of the face, describing the Devine Ratio of 1 to 1.618, or the Phi Ratio as it is called today.  The ratio of the width of the nose to the length of the nose is, guess, 1:1.618, as is the ratio of the upper lip to the lower lip and many other facial features.  da Vinci used these universal proportions in creating his art, as in the face from John the Baptist below.Rena John the Bapist angel Leonardo

Those of us practicing facial aesthetics today are blessed to have a wide array of safe and effective products and treatments to re-create natural beauty on the aging face.  The best compliment that I receive is, “I look like myself, just a better version of myself!”  By using the golden ratios of natural beauty I am able to artfully create the natural curves, fullness, hollows, light, and shadows of youth.

rena ogee curve

Above, note the S-shaped curve on 3/4 view of the right cheek (corner of eye to chin).  This is called the Ogee Curve of youth and can be re-created with facial fillers such as Voluma and Sculptra.  Note also how there are no harsh shadows and that the facial subunits blend together with each other in smooth transition.

rena Head of an Angel Leonardo da Vinci

In da Vinci’s “Head of an Angel” (above), note the full cheeks, the Ogee Curve, the fullness of the lips and the upward orientation of the corners of the lips.  The jawline is smooth and well defined, the nasolabial fold is present but does not cast harsh shadows.  There is fullness of the peri-orbital (around the eyes) region and smoothness of the forehead (think Botox, Dysport.)

Candice Swanepoel, one of  the most beautiful Victoria’s Secret Angels, shares the classical natural beauty features described above.  I have not treated Candice, nor do I know whether or not she has had any facial aesthetic treatments, but her facial feature ratios measure out to, you guessed it, the Devine or Phi ratio of beauty, 1:1.618.  I have treated a few of today’s Angels and look forward to treating many more in the future, but I will always keep in mind the natural proportions defined by da Vinci and  the beauty of the Angels of the Renaissance.

 

The most important aspect of any aesthetic treatment, procedure, or surgery is making sure that you choose your treating physician extremely carefully based on their skill, experience, knowledge, and natural artistic vision.

Art is never finished, only abandoned.
– Leonardo da Vinci

Leonardo da Vinci never signed his works of art because he felt that they were never done.  Fortunately the same can be said about maintaining beautiful facial aesthetics.  Be well.

The Future of Aesthetic Medicine, It May All Be in Our Head

Beautiful young people are accidents of nature, but beautiful old people are works of art.

                                                                                                                           ― Eleanor Roosevelt

From the title, I bet that you are expecting to hear about the latest, greatest techniques, products, devices, and surgeries that will be at the forefront of aesthetic medicine in 2016 and the coming years ahead. Actually, one of the greatest advances in facial plastic surgery is our realization of how important our mind is in determining how attractive we are.

In spinning class yesterday our twenty-something instructor was sharing how happy the class looked and yelled out, “Look young!” What she really was inferring was “Feel young, and you will look young!” Looking young in of itself does not lead to happiness. There are many unhappy young looking people. Feeling attractive and young does lead to happiness. The difference between looking and feeling young is similar to the difference between beauty and attractiveness. Beauty does not necessarily lead to happiness (we all know many unhappy beautiful people), yet when one feels attractive, one is generally happy. No matter what your age, when you feel attractive, you also feel young; you are happier, more confident, and have greater self-esteem. The same can be said for beauty and attractiveness. When we feel attractive we have greater self-esteem, feel confident, and are generally happier, all of which leads us to feel more beautiful.

Spending most of my time helping my patients appear younger by using Botox, fillers, devices, and surgery, it struck me that we can “look young” both with and without these tricks of the trade.

My goal in aesthetics is to help people feel attractive. Attractive people are happy people. Our mood is affected by our facial expressions. Smile and you are immediately more attractive; frown and you are less attractive, less desirable. Our subconscious brain can sense the expression on our face at all times. Smile and the world smiles with you, frown and you not only look unattractive, but the people you interact with reflect that unhappiness back upon you.

Smiling sets off a positive cascade of reactions both from others and within us. Recent studies have proven that expressions on our face directly affect our feelings and mood. These studies show that botox is as effective at treating depressed mood as taking daily anti-depressants. Unhappy facial expressions are related to depression. Depression has been shown to improve by changing the expression of the face from a grimace or frown to a smile. Botox, fillers, surgery, make-up, and nutraceuticals have also been shown to improve mood. Positive facial expressions are correlated with a better quality of life and even with better marriages. By increasing self-esteem and confidence people feel happier.

As Billy Crystal said, “When you look marvelous, you feel marvelous.” What we now realize is that we can influence how good we look by how we feel inside, and vice versa. Our goal in facial plastic surgery is to help our patients feel good about themselves by being more attractive; improving their natural beauty is a by-product and icing on the cake!  Smile, be well!PERSKY BEARD

Best Way to Minimize Bruising From Facial Filler Injections…”Bruise ‘Em, You Lose ‘Em”

Facial filler and Botox injections have become the most popular facial aesthetic procedures.  One of the most common complications of facial injections is bruising.  We believe that expert injectors should do everything possible to minimize bruising patients.  We have been fortunate to treat hundreds of patients each month with a very tiny percentage having any significant bruising after their treatment.

Kim Kardashian's bruises after Botox injections

Kim Kardashian’s bruises after Botox injections

Minimizing bruising from facial injections begins at our initial consultation.  A patient with a history of any previous bleeding problems,  use of medications that “thin” the blood, or high blood pressure are treated only after those situations are controlled.  We ask our patients to stop any medications that increase the chance of bleeding (aspirin, Motrin, Alleve, Advil, etc.) for at least 10 to 14 days.  High blood pressure is controlled before treatment.

Bruising can be minimized by using the smallest needles available.  An expert injecting physician knows facial anatomy and avoids traumatizing blood vessels.  If any bleeding is suspected after an injection, manual pressure on the area is maintained for a few minutes.  Ice may be used.  If we suspect that there is any chance of a bruise, we put a Arnica gel patch on the area.  Patients wear the patch for 6 hours and then place a new patch on before bedtime and sleep with it.  These Arnica gel patches have been incredible in minimizing bruising in our patients.

As my brilliant plastic surgeon colleagues Arthur Swift, MD (Montreal, Canada) and Kent Remington, MD (Calgary, Canada) say, “You bruise them, you lose them!”  We like to keep our patients and help them achieve and maintain their facial aesthetic goals for many years.  Be well!

Complimentary Expert Facial Analysis, Michael Persky, MD

The three comments that I often hear both in the office and socially are:

“Dr. Persky,can you tell when someone has had some plastic surgery done?”

 “Doc, why does everyone who has plastic surgery look the same?”  

“I want to look better, but I don’t want those big apple cheeks and hugh lips!”

Jennifer Lopez, People Magazine's 2011 Most Beautiful Woman in the World

Jennifer Lopez, People Magazine’s 2011 Most Beautiful Woman in the World

We all can tell when someone has had obvious plastic surgery.  If our treatments result in a obvious “done” result, then we have failed as plastic surgeons.  These obvious  cases of poorly performed aesthetic treatments without a sense of artistic vision may “all look the same.”  They have the same big lips, big cheeks, and paralyzed facial expressions.

j LoConversely, when plastic surgery or aesthetic treatments  are performed properly resulting in a natural appearance, then most of us, including myself and other expert plastic surgeons cannot tell that anything has been done.

The way to achieve your goal of looking better, a better more rested youthful version of yourself, is to make sure that your aesthetic physician is well trained, skilled, knowledgable, and most importantly posesses a natural sense of artistic vision.

ferrariBeauty is perceived and appreciated in a blink of the eye, in a millisecond.  Our brains are programmed to see natural proportions, symmetry, light, shadows, and highlights and immediately tell us if someone (Jennifer Lopez) or something (say a Ferrari) is beautiful and proportioned.  On the other hand, if a face is disproportionate, our subconscious primordial brain immediately tells us that the appearance is unhealthy, infertile, and someone with whom we should not exchange DNA with for the sake of our species ultimate survival; they look like freaky aliens.   All the while, our cognitive or verbal response is often, “She/he looks ‘funny’.  What did they have done?”

At your initial consultation as well as at each of your subsequent visits, Dr. Persky uses his expert sense of artistic vision to analyze your face.  This analysis allows Dr. Persky to give you your blueprint for natural rejuvenation.  The analysis includes your forehead, eyebrows, eyes,  nose, mouth, neck, as well as your skin tone, texture, and color.  Your overall facial shape and natural Ogee curves are considered as well.

da vincis proportions

The face can be divided into thirds horizontally (the forehead, the mid-face, and the mouth) and vertical fifths, each the width of the distance between the inner corners of the eyes (the only measurement on the face that does not change with aging).   Leonardo da Vinci described the “Devine Golden Ratio” or “Phi” over 500 years ago and it is as relevant today as it was when the Mona Lisa was painted (did you know that da Vinci never signed his works as he believed that a work of art was never complete!)  Dr. Persky uses a Phi caliper to measure the distance between your eyes, and uses that and his built-in artistic sense of proportions as a guide to restoring your face to it’s natural appearance before the aging process of volume loss of bone and fat began (unfortunately it begins in all of us from about age 25 on).

Mona_Lisa,_by_Leonardo_da_Vinci,_from_C2RMF_retouchedDr. Persky loves to discuss beauty and natural proportions with his patients.  Please call and schedule your complimentary facial analysis with Dr. Persky.  Be well!

Rejuvenating Hands Encino, Los Angeles, Ca

As stated by Dr. Persky, MD, Persky Sunder Facial Plastic Surgery, Encino:

Points from the Video:

00:32- The most popular filler for adding volume to the hands is radiesse;

00:50- Radiesse is very malleable, and so when we inject it, we just massage it into place;

01:05- We will often combine laser resurfacing at the hands which takes away the brown spots and helps with some other fine lines and wrinkles;

01:18- Radiesse in the hands lasts about a year or two;

In facial plastic surgery, we spend most of our time rejuvenating the face. We hear often from patients that my face looks great, but when I bring my hands up to talk or drink or eat, it’s a dead giveaway of a patient’s age when the hands don’t match with the face or neck. So we do treat hands quite often and in rejuvenating the hands, what we do most of the time is use fillers. The most popular filler for adding volume to the hands is radiesse. It is performed in a quick in-office procedure that’s relatively comfortable; a syringe of radiesse is injected into both hands; radiesse is very malleable, and so when we inject it, we just massage it into place, and what it does is it helps to add volume to the face, it diminishes the appearance of the veins of the hand. If patients want to go beyond that, we will often combine laser resurfacing at the hands which takes away the brown spots and helps with some other fine lines and wrinkles. Radiesse in the hands lasts about a year or two; there is some new collagen stimulation when you place it there. So even when it goes away, the hands look a little bit better. It’s a nice relatively inexpensive way of matching the appearance of the hands to the face.

image001Dr. Michael Persky and Dr. Sarmela Sunder are located in Encino, California and Beverly Hills, California but service all of Los Angeles and the San Fernando Valley. Including, Beverly Hills, Hollywood, Hancock Park, Brentwood, Santa Monica, Pacific Palisades, Malibu, Sherman Oaks, Studio City, Calabasas, Woodland Hills, Tarzana, Westlake, Thousand Oaks, Agoura Hills, La Canada, Pasadena, and more. Please subscribe to our blog by clicking the link above, right, and “Like” us on Facebook. Thank you! + Michael Persky

Overdoing Plastic Surgery Encino, Los Angeles, Ca

As stated by Dr Michael Persky, MD, Persky Sunder Facial Plastic Surgery, Encino:

Points from the Video:

00:14- There is a very-very small percentage of patients who really get endorphin type release and happiness with a procedure;

00:50- We have to evaluate whether it is something that is beneficial to the patient;

01:10- If I cant improve upon it, then I let the patient know that;

With all the amazing things that we can do in facial plastic surgery, fortunately, most of out patients are extremely happy with the results. Unfortunately, there is a very-very small percentage of patients who really get endorphin type release and happiness with a procedure and that can lead to almost an addiction to facial plastic surgery procedures. It is important for the individual physician to recognize this in patients. Personally, when a patient comes to me and requests either multiple procedures or procedures after having had other procedures, we have to evaluate whether it is something that is beneficial to the patient. I look to see if a patient complains of something, if there is actually something there that I can improve upon; If I cant improve upon it, then I let the patient know that. Unfortunately, there are many cases where patients will drive a physician or a treatment to beyond where it is indicated and I think we have examples of that in celebrities like late Michael Jackson probably had far too many facial procedures, particularly on his nose and skin color. Heidi Montag is on film documenting feels that she had too many procedures at one time; and so, it is really important for you to see a physician who is able to be realistic with you and frank with you in telling you that you are looking for a little bit of too much; and here at Persky Sunder, both Dr Sunder and I both believe in being truthful to our patients and often times will turn down requests for procedures if we don’t think they are indicating.

image001Dr. Michael Persky and Dr. Sarmela Sunder are located in Encino, California and Beverly Hills, California but service all of Los Angeles and the San Fernando Valley. Including, Beverly Hills, Hollywood, Hancock Park, Brentwood, Santa Monica, Pacific Palisades, Malibu, Sherman Oaks, Studio City, Calabasas, Woodland Hills, Tarzana, Westlake, Thousand Oaks, Agoura Hills, La Canada, Pasadena, and more. Please subscribe to our blog by clicking the link above, right, and “Like” us on Facebook. Thank you! + Michael Persky

You’re Beautiful Just the Way You Are Los Angeles, CA

As stated by Dr. Michael Persky, MD, Persky Sunder Facial Plastic Surgery, Encino:

Points from the Video:

00: 05- Our patients come to us for evaluation, recommendation of their facial beauty;

01:20- I think, one of the biggest crimes we can do against our patients is creating that overly done look with big lips and big cheeks in a young woman;

01:40- And you get that homogenization of the look and there is nothing worse than someone taking who is young and beautiful and making them look plastic;

Our patients come to us for evaluation, recommendation of their facial beauty; we must use our artistic vision to give them a realistic analysis of what we think is going on their face. One of the things I enjoy the most about coming to work is being able to evaluate people, and in doing that, there are some patients who come and request fillers to treatments that they really don’t need, and I have said before that in our console room, we have lyrics to Bruno Mars ‘You’re beautiful just the way you are’ and often times, in those types of patients who are young and may not need something but feel that they do, I just pull out those lyrics and hand it to them, and say come back in a few years. And I warn them that if they go to other practices or other physicians, they are going to find somebody, who for some money, will do something to them, and unfortunately, I think, one of the biggest crimes we can do against our patients is creating that overly done look with big lips and big cheeks in a young woman, who now looks like she is a 40 or 50 year old woman who has had those procedures done and is trying to look younger. And you get that homogenization of the look and there is nothing worse than someone taking who is young and beautiful and making them look plastic; and certainly we don’t do that to any of our patients but unfortunately, there are those out there that are creating some very unnatural looking appearances.

image001Dr. Michael Persky and Dr. Sarmela Sunder are located in Encino, California and Beverly Hills, California but service all of Los Angeles and the San Fernando Valley. Including, Beverly Hills, Hollywood, Hancock Park, Brentwood, Santa Monica, Pacific Palisades, Malibu, Sherman Oaks, Studio City, Calabasas, Woodland Hills, Tarzana, Westlake, Thousand Oaks, Agoura Hills, La Canada, Pasadena, and more. Please subscribe to our blog by clicking the link above, right, and “Like” us on Facebook. Thank you! + Michael Persky

Social Media and Plastic Surgery, Los Angeles, CA

As stated by Dr Michael Persky, MD, Persky Sunder Facial Plastic Surgery, Encino:

Points from the Video:

00:12- With the increased use of selfies and the facebook, and other social media applications where our faces are there online, patients see themselves a lot more often;

00:53- We are seeing a lot more patients who are wanting to look better for their social media appearances;

There have been many articles recently about social media and its effect on facial plastic surgery. With the increased use of selfies and the facebook, and other social media applications where our faces are there online, patients see themselves a lot more often and they see themselves in positions that they don’t usually see themselves in during a usual kind of photography. So when you are taking a selfie and you are down here like this, your neck shows or your eyes are looking a little bit funny and distorted; some patients want to have procedures done; so yes, we are seeing a lot more patients who are wanting to look better for their social media appearances.

image001Dr. Michael Persky and Dr. Sarmela Sunder are located in Encino, California and Beverly Hills, California but service all of Los Angeles and the San Fernando Valley. Including, Beverly Hills, Hollywood, Hancock Park, Brentwood, Santa Monica, Pacific Palisades, Malibu, Sherman Oaks, Studio City, Calabasas, Woodland Hills, Tarzana, Westlake, Thousand Oaks, Agoura Hills, La Canada, Pasadena, and more. Please subscribe to our blog by clicking the link above, right, and “Like” us on Facebook. Thank you! + Michael Persky

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