Botox Archives - Dr. Persky

There is a new kid on the “wrinkle fighting” block, it’s named Daxxify. Daxxify (Revance Corp, Nashville TN) is the newest FDA approved neuromodulator, joining Botox, Dysport, Jeuveau, and Xeomin. Michael A. Persky MD (Encino, CA) is a board certified facial plastic surgeon who’s practice is dedicated to non-surgical facial rejuvenation with natural results. Daxxify has been proven to last twice as long as patients previous neuromodulator treatments. In other words, if your Botox or Dysport has typically lasted for 3 to 4 months, then we expect that your Daxxify treatment will last for 6 to 8 months. There is about a 50% additional premium paid for the longer lasting Daxxify treatment, though you will not need to visit the office as frequently. As with other neuromodulators, Daxxify is used to treat the glabellar lines between the brows (“11 lines”), the eye smile lines (“crow’s feet’), forehead wrinkles, and all of the other areas that Botox may be used. Dr. Persky recently spoke at the Los Angeles Multi-speciality Cosmetic Meeting 2023 at The Four Seasons Hotel Beverly Hills on an expert neuromodulator panel. Please feel free to contact our office regarding any questions that you may have regarding Daxxify or any facial cosmetic procedure. We look forward to the privilege of helping you achieve and maintain your facial aesthetic goals for many years to come.

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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.

Recent 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 COMBO The 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 Aug duck’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

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

Points from the Video:

00: 12- When should someone start to combat facial wrinkles?

00:44- Usually, it is young women who want a little botox;

01:04- Wrinkles don’t really start appearing till at least the later twenties;

01: 14- One of the causes of wrinkles is losing volume;

01: 30- The earliest time to consider botox is may be in the late twenties or early thirties;

Taxes, death and facial wrinkles are inevitable. When should someone start to combat facial wrinkles or even the far of facial wrinkles? Certainly, we have patients coming in who are quite young who want something done, and usually for those patients, nothing beats you, let’s face it. So for those patients, I’ll reach my drawer and take out a piece of paper and on that piece of paper, the lyrics from Bruno Mars –‘You are beautiful just the way you are’, and I say we will see you in a few years. Usually it is young women who want a little botox, they want a little bit of lift right here. We put a drop of botox in the procerus muscle and a drop of botox out here, may be 4-6 units, and they get a nice little lift and rejuvenation. But wrinkles don’t really start appearing till at least the later twenties. We do start losing volume in our face from 24-25 years on and one of the causes of wrinkles is losing volume. So, I would say that probably the earliest time to seriously consider botox is may be in the late twenties or early thirties, but I would say that great majority of patients have botox in their forties, fifties and sixties.

Dr. 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

“Beautiful young people are accidents of nature. Beautiful older people are works of art” Eleanor Roosevelt

Voluma is revolutionizing facial plastic surgery and facial aesthetics. Sarmela Sunder, MD and Michael Persky, MD were privileged to attend Dr. Mauricio de Maio’s “Master Course” in Los Angeles, CA this week.

Voluma (Actavis, formally Allergan), a cross-linked hyaluronic acid is the only injectable filler that is strong enough to correct facial sagging. Sagging as we all know is a nasty word, and an even nastier term when applied to ourselves. In the past, injectable fillers have been directed towards correcting lines and wrinkles. Let’s face it (no pun intended), as Dr. di Maio asks, “Would you rather have someone tell you that your face has lines or tell you that your face is saggy?” Voluma corrects saggy!!! Along with correcting saggy, lines and wrinkles improve as well.

At the eight hour live injection session we were privileged to inject 6 women in their 40’s under the guidance of the artistic and experienced eye of Dr. di Maio. Using Voluma in the most efficient, safe, and effective manner combining our injection skills and artistic vision along with Dr. di Maio’s almost 10 year experience of injecting Voluma (FDA approved for use in the US only since Dec 2014) by the end of the injection session all 6 women were extremely pleased with what 2-3 cc of Voluma did for them. Here is the text message that we received the following day, “Hi Dr. P!! I LOOOOVE everything!!! Thank you so much!!….”

Each Voluma patient was asked what they liked best about their cosmetic result. Amazingly, every patient commented about how they loved how their jawline and neck appeared to be lifted. They also loved how Voluma lifted their eyebrows and improved the appearance of their eyes. These effects resulting from knowing where and how to inject Voluma in the proper anatomic location to maximize it’s lifting capability. The knowledge and experience gained this under Dr. di Maio’s tutelage will greatly benefit our patients going forward.

Another important benefit of The Master Course is knowing where to not inject filler in patients, the so called “No Go Zones” to avoid causing sagging, nasolabial fold “sausages”, and the dreaded “apple cheek.” As Dr. di Maio stated in his Brazilian accent, “No human being should be made to look saggy by our treatments.”

Knowledge of the proper facial anatomy is essential for safe injections and minimizing the risk of adverse events. Dr. di Maio drew out the important facial landmarks including blood vessels, nerves, muscles, fat pads, and bones on live models. Once again, as with all aesthetic procedures, it’s not just the product, but it is how it is used, the technique and philosophy of it’s use! Hence the importance of choosing your facial plastic surgeon most carefully.

Voluma, when used properly by experienced, skilled injectors with natural artistic
vision, is a true aesthetic game changer, reversing the effects of gravity on the face and neck. It is our firm belief that every patient above the age of 30 years old can benefit from Voluma. In this day of selfies and iPads/iPhones, women in their 30’s are seeing the signs of loose skin, early signs of jowls, and mid-face hollowness. Voluma can replace lost structure, restoring the foundation that keeps our skin in place, even when we tilt our head down. Try it yourself. Look in the mirror with your chin to your chest. Now check out your jawline and jowls. In youth, facial and neck skin stays where it belongs even when looking down, but as we age, it folds and falls. Worse yet, the older we get the more things fall and sag. Now we finally have an answer that defies gravity, Voluma! By the way, when taking those selfies, always take them from above, you will thank us for that! As Dr. di Maio said, our Voluma treatment goal is for you to “Live Your Life, Tilt Your Head Down!” and “To not look saggy when using your iPad!”

Voluma is stronger and lasts longer than all other fillers, therefore it costs more than other fillers. In premier practices such as Persky Sunder Facial Plastic Surgery, you are receiving not only Voluma, but most importantly you benefit from our technique and philosophy of it’s use. We are among a select few of Voluma experts in the United States, having injected over 500 syringes last year and having attended five di Maio Master Voluma Courses. For those able to afford complete corrective Voluma treatment, dramatic rejuvenating results are obtained in a 30 minute treatment session. For those on limited budgets, The Master Course has given us the tools to treat sequentially over time and multiple visits, using Voluma in the area where our patients get their biggest bang for their buck. When their budget allows for more, we add on to their correction with further strategic placements of Voluma. Voluma lasts up to two years when the proper volume is used.

Feel free to contact us with any questions that you may have regarding Voluma, facial plastic surgery, or natural beauty in general. Be well.

persky selfie Seems like we have seen at least 10 social media articles a day since Thanksgiving asking, “Are Selfies Leading to More Plastic Surgery Procedures?” The answer is a resounding, “Yes!!!” E’nuff said!

Social media sites Facebook, Instagram (owned by Facebook), Twitter, and others have millions of self taken images for both the subject and the world to see. Add to that the online dating sites, and “looking’ good” has never been more popular.

The focus of the face should be on the eyes, the “windows to the soul.” Selfies, because they are by definition taken by the person in the image, are taken from bad angles which usually accentuate any minor facial flaw, drawing attention away from the subjects eyes. This leads patients to seek treatment of what bothers them on their selfie photo.

Whether it is something minor that is corrected non-invasively with a few units of Botox or a syringe of Voluma, or something that requires surgery such as rhinoplasty to remove a hump from the nose, or a mini-face/neck lift for the jowls and neck, the treatment should result in a natural appearance that returns the focus of the face to the subject’s eyes.

When choosing your facial plastic surgeon, take your time, do your due diligence, and make your decision based on their skill, experience, and most importantly their natural artistic vision.

As for my selfie above, fortunately there is a double standard in our society whereby men can get away with more aging, thus I will just perform and write about more facial plastic surgical procedures based on my selfie rather than seek treatment for that funny looking face. Be well!

Using 3 of Allergan’s products on our patients who wish to look their best is giving an amazing immediate transformation, taking years of aging away in minutes. We begin “The Allergan Facial Rejuvenation” with a detailed facial analysis, evaluating where the individual can best use volume to support the rest of the face. It is helpful to have a photo of the individual when they were in their mid 20s to 30s to have something to compare.

Voluma is used first to restore volume to the cheeks, often resulting in improvement of the lower eye lid hollow, the nasolabial fold, the vertical mid-cheek lines, and the jawline. Second we use Juvederm XC Plus to re-inflate the lips and correct the dreaded smoker’s lines around the mouth. A small amount of Juvederm can be used in the nasolabial folds (laugh lines) if needed. The third product that we use is Botox to treat the “11” lines of the forehead, to lift the eyebrows, treat the crow’s feet, and any other areas that would benefit from it’s use.

The Allergan Facial Rejuvenation results in an instantaneous natural youthful apppearance in the hands of Drs. Persky and Sunder. Feel free to contact us with any questions that you may have regarding facial cosmetic surgery. Be well.

You may go to this site to see actual patient results with just Botox: http://www.botoxcosmetic.com/en/SeeResults/BeforeAfter.aspx

“>Dr. 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

“As long as a woman can look younger than her daughter she will be happy.”
Oscar Wilde in “The Portrait of Dorian Grey”

A recent survey by The American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) suggests that “50 is the new 30.”

I think that saying “50 is the new 30” is a bit of an exaggeration. Maybe 50 is the new 39 is more accurate.

The AAFPRS survey asked the opinions of approximately 500 women between the ages of 45 and 60 years to find out what they think about the changing face of 50. On average, 69% of women reported feeling at least 6 years younger than their chronological age. Furthermore, women in their 50s still feel sexy, vibrant, beautiful and desirable.

Many women (and men) in their 40’s and 50’s are taking advantage of the revolutionary advances in facial plastic surgery to look as young on the outside as they feel on the inside. Thanks to many of the non-surgical techniques as well as recent conservative surgical options, the stigmata of “plastic surgery” has changed from vanity to being excepted. Today’s patients desire to look their best in a natural manner (no comment on The Housewives of Beverly Hills or Miami!).When it comes to reversing the hands of time they demand a natural results — they want to be the best, most youthful and attractive version of themselves they can be, without looking drastically different.

The most minimal treatment with Botox can make a few wrinkles disappear, resulting in patients feeling better about themselves, having increased self-esteem and confidence. This leads to the patient being more attractive (not necessarily more “beautiful”), and they carry themselves in a more beautiful manner from inside out.

Among 40 and 50 year olds in our practice, two very popular treatments are Ultherapy and Sculptra. I have treated many of my wife’s 40 and 50 year old friends with Ultherapy. One of her friends just told me this story. A recent photo of a “girls night out” birthday celebration posted on FaceBook resulted in her ex calling her and saying, “It looks like Dr. Persky has been doing a surgery on you girls, you all look like you are in your 30’s!” Though having had Ultherapy a few years ago along with a touch of Botox here and there, she denied any surgery to which he stated, “Well the next time I see you I will be checking you for facelift scars.” The benefit of Ultherapy in women in their 40’s and 50’s is that the early signs of aging (jowls, loss of facial volume, loose neck skin, and dropping brows) can be addressed without surgery. Whereas 20 years ago, women’s faces aged until they had a drastic face/neck surgery, today they are staying youthful with non-invasive technologies, skin care, exercise, and even dietary supplements such as Glisodin.

According to the surgery, “72% of the women surveyed have tried skin peels, while 50% have had injections of neurotoxins or fillers, and 15% have had cosmetic facial surgery. However, even with the increased amount of treatment options to turn back the clock, 70% of women stated that a milestone birthday did impact the way they feel about their appearance. Twenty-four percent were most concerned with looking their real age, with sagging cheeks or eye bags (39%), fine lines and wrinkles (33%), and the dreaded ‘turkey neck’ effect (28%) topping their list of aesthetic concerns.”

Billy Crystal’s character on Saturday Night Live used to say, “When you look Mah-vah-lous, you feel Mah-vah-lous”, today’s 40 and 50 year old women are looking marvelous, leading to them feeling marvelous with increased self-esteem, confidence, and attractiveness.

Recent studies have shown that patients who are treated with Botox or Dysport have a certain extent of euphoria for a few months after their treatment. It has also been shown that Botox or Dysport injections can help patients who suffer from depression feel less depressed. Now, Dutch researchers compared cell structures called telomeres in more than 2,400 people with and without depression.

Telemeres shorten as our cells divide, therefore they are an excellent marker for aging. The Dutch scientists found that patients with a history of depression had telemeres that were significantly shorter than those patients who never had depression. It has been shown that aging is directly related to the length of telemeres, those with longer telemeres do not age as quickly as those with shorter telemeres. The amount of shortening seen with depression correlates to about 4 to 6 years shorter life.

So again, the old Saturday Night Live skit with Billy Crystal saying, “When you look Mah-vah=lous, you feel Mah-vah-lous” is supported by scientific studies. Cheer up, you will age slower. Be well!

To see the complete article,”Cells Show Signs of Faster Aging After Depression”, go to: http://www.everydayhealth.com/depression/1112/cells-show-signs-of-faster-aging-after-depression.aspx?xid=aol_eh-emo_3_20131111_&aolcat=HLT&icid=maing-grid7%7Chtmlws-main-bb%7Cdl28%7Csec1_lnk3%26pLid%3D404940

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