Andrew Erikson wrote a very good piece today published in Paul Callaway's blog about fractionated CO2, with an excellent guide on how to choose your treating physician. Mr. Erikson stresses the importance of choosing the most experienced and skilled laser physician with the particular device.
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The study of youthful, beautiful faces reveals two common findings. A youthful face has adequate volume or fullness, and secondly, the skin appears flawless and well hydrated. With aging, we lose volume from our faces through the loss of fat, bone, and muscle. The skin ages due to loss of underlying support as well as from sun damage. Rejuvenation of the face can be achieved by "puffing and buffing" (PB). I originally referred to the treatment as buffing and puffing (BP), but after the BP Gulf oil disaster thought that PB was more appropriate.
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Take time to enjoy the beauty of life, a wise philosophy.
Over the next two weeks we have the privilege of observing the world's greatest athlete’s compete in the 2010 Vancouver Winter Olympic Games. The beauty of the Olympians, their specialized trained bodies, instantaneous split second reactions, their focus on task all are worthy of artful inspiration. Enjoy the beauty of the 2010 Olympic Games.
Our deepest prayers of sympathy and support go out to the family, teammates, and friends of Georgian luger Nodar Kumaritashvili. We pray that his soul is bound to eternal life.
Old man time, he’s so mean
Meanest man you’ve ever seen
He gives you youth; then he steals it away
He takes your nice pretty hair; turns it gray.....
He gives you beauty charm and grace
Then puts wrinkles on your face.
Those are a few of the lyrics of Jimmie Durante's old song "Old Man Time". I was approached by a young, 49 year old woman, at the gym a few weeks ago. We had spoken about my practice as a facial plastic surgeon many years before. She told me that she was "turning 50" and wanted to come in for a little rejuvenation of her face, and asked what I would do. She said that her husband is not a big fan of plastic anything, but that he would be willing to give her a 50'th birthday present at my office if that is what she wanted.
She asked the common question that makes those in my profession cringe. We are too often asked, usually in front of too many others, "What would you do to improve my face?" Having grown up in a household with two sisters, no brothers, now living with two daughters and no sons, and working with seven women, no men, I know how to answer the question....with calm silence followed by, "What bothers you?"
She is the perfect example of an athletic, fit, good looking woman who has never "had anything done". Loss of volume in the face particularly in the temple area, the cheeks, and jaw line result in nasolabial folds and early jowls, and a overall tired look. Sculptra is an excellent choice to use to return her face to a more youthful oval, fuller, rested state.
By 50, most upper eyelids have a bit of excess lax skin that can be easily remedied with an upper eye lid skin only blepharoplasty performed under local anesthesia in the office. Four days of stitches, five to seven days of minimal bruising, and wah-la, a much younger appearance. Her lower eyelid hollows could be corrected with a small amount of Restylane.
Lastly, the sun damage from those days at the beach. Fraxel Dual is a revolutionary new wavelength (Thulium 1927) that enables better treatment of pigmentation and other dyschromia on the entire body with minimal discomfort.
So with a little hair coloring, diet, exercise, and a short trip to Dr. Persky's office, Old Man Time doesn't have to be as "mean" as he was when Jimmie Durante sang his song.
....So you don't ever have to fret
Fall in love and you‘ll forget
That’s old man, old man time…
Yes old man, old man time.
Happy Birthday!
Facial plastic surgery is in the midst of a revolution. It is now well accepted that the aging face results from loss of volume. There is loss and remodeling of bone and fat as we age. Thanks to the dedicated research and clinical studies by Val Lambros MD, Sidney Coleman MD, Danny Vllegar MD, Rebecca Fitzgerald MD, Joel Pessa MD, Rod Rohrich MD, and Sam Lamm MD to name just a few, plastic surgeons, facial plastic surgeons, and cosmetic dermatologists are in the midst of changing how we have addressed the aging face for the past 50 years.
Today, a large percentage of patients are able to be rejuvenated without surgery. Instead of cutting and pulling, we are filling and buffing. By replacing lost volume, natural youthful facial contours are restored. The choice of material to replace volume varies and includes Juvederm, Restylane, and Radiesse; newly FDA approved "for cosmetic use" Sculptra, or a patient's own fat. The tone, texture, color, and additional tightening of facial and neck skin can be further enhanced with fractionated CO2 laser treatments such as Fraxel repair.
By combining volume replacement with fractionated CO2 laser skin resurfacing, patients achieve their goal of looking healthy, youthful, and natural without the need for general anesthesia, operating rooms, or scalpels.
As evidenced by the emphasis of volume replacement and fractionated CO2 laser skin rejuvenation lectures and instruction courses at our national and international dermatology, facial plastic, and plastic surgery meetings, there is truly an unprecedented revolution occurring in the treatment of the aging face. In patients with excessive skin redundancy, there will still be the need for surgery. For the most part though, the future facial cosmetic surgeon will likely be asking, "Syringe please" instead of "Scalpel".
The film "The Picture of Dorian Gray", based on the 1890 novel by Oscar Wilde opens next week. It is the dreamlike story of a young man who sells his soul for eternal youth and beauty.
The ads for the movie cry out "FOREVER YOUNG" and "ETERNALLY PERFECT".
The parallels between Wilde's 1890's and today's facial cosmetic surgery are striking. Our desire for beauty and looking our best pre-dated even Wilde's era by thousands of years. The African beauty Queen Nefertiti and Egypt’s Queen Cleopatra stand out among others in "the quest for beauty’s" long history.
Preceding the cosmetic use of Botox by 100 years, one of Wilde's characters, Lord Henry tells Dorian, "Good heavens, my dear boy, don't look so tragic! The secret of remaining young is never to have an emotion that is unbecoming." Sound familiar? Looks familiar looking at the Botoxed faces of "Desperate Housewifes". Most of us wish to look our best, or at least "as young as we feel". Lord Henry seems to agree when he tells Dorian, "The tragedy of old age is not that one is old, but that one is young." Well, enough of this gibberish, enjoy the movie, even better read the book, and as Rod Stewart says, "May you stay forever young." Be well.
Dr. P
Disclaimer: The image above is intended to serve an aesthetic purpose only and is not meant to reflect the practice of our office in any way
I was recently asked on RealSelf.com a question about the injection of Radiesse filler for "marionette lines". The patient had received filler in the past that made her jaw and chin look masculine. She wanted to avoid this look when injected with the longer lasting Radiesse product.
Here is my answer.........
"Your question emphasizes the importance of choosing an injector physician who has the proper eye for facial proportions and beauty.
Injecting the marionette lines is not a commodity that you arrive at the physician's office (or as seems to be the trend nowadays the spa, nurse's house, or podiatrist's office) and order up like a Strawberry and Cream Latte with White Chocolate powder at Coffee Bean.
There is an art and science to injecting, and every patient is a little different.
The judgment and experience of the injector is important. As the saying goes, 'Good judgment is based upon bad experiences; good experience is based upon bad judgments'.
Sounds like you have already had a bad experience in the past; hopefully it has helped your injector's judgment."
Good luck and is well......
One of the nicest compliments that can be given or received is "What a kind face you have."
What makes a kind face? Start with the best form of plastic surgery.....smiling. Add a little sparkle of soul to the eyes. Care about others and help others. Get fresh air, exercise, and don't spend much time texting or hooked to electronic communications. Stay hydrated and wear sun block. Be grateful. Breathe deeply and often.
Once all non-cosmetic remedies have been exhausted, eliminating or softening the angry look of furrowed eye brows with a little Botox, and turning up the drooping corners of the mouth with a touch of hyaluronic acid filler (Juvederm or Restylane) will change a sad, or angry appearance to a happier, friendly, kinder look.
Or you can follow the lead of an Old English Sheep Dog, probably the friendliest dog known to mankind with the kindest face. Woof, woof!
The image above is intended to serve an aesthetic purpose only and is not meant to reflect the practice of our office in any way.
