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

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

Points from the Video:

00: 17- When is the best time to start filling the face?

00:46- It is pretty good to leave patients alone in their twenties;

01:08- The area that we use the earliest for filler is the lips;

01:35- Trauma of the needle creates enough swelling;

02:00- A small amount of sculptra helps things look better;

02:15- In thirties and forties, we can use ulthera to create a lift;

02:30- We love to use voluma in the cheeks;

Lot of patients are obsessed with their facial appearance; we have lot of actors and actresses in this area, lot of newspeople, television personalities. So when is the best time to start filling the face? One of my pet peeves is the recent appearance of a lot of apple cheeks, and again, anything that we do that is obvious, we have failed our patients. So, the most natural thing about youth is youth. So it’s usually pretty good to leave patients alone in their twenties. We start losing volume in our face from about 25 years on; we lose bone, we lose fat, we lose muscle. Each individual patient is going to age differently, so there are different things that can be done. Probably the area that we use filler the earliest is our lips, and we have some patients even in their teens and twenties that genetically just were born with small lips who want a little improvement there. It’s ok to start at a young age, but lips have been abused in the past and we don’t want lips that are walking in the door before the patient. So you have to be very careful with that and I find that almost in some of these patients, we are able to almost pass the needle and just the trauma of the needle creates enough swelling that they are happy with the improvement. In terms of actual facial filling, again late twenties or early thirties, patients can benefit from a little bit of more volume and I find that using sculptra in the proper areas, may be a small amount of sculptra helps things look better. As patients get into their thirties and forties, we can use things like ulthera to create a little bit of lift; when we lift here, there is a bit of volume in the cheeks. And from forties, it really depends on what is lacking in the patient, but in the thirties and forties, we love to use a little voluma in this area because by placing volume in this area, you get improvement under the eyes, you get improvement in the nasal labial folds, you get improvement in some of the wrinkles here, and you get improvement in the jaw. So, again by knowing a proper area to place a filler, the proper filler and the proper treatment, we can treat patients at all ages, but you want to stay as natural as possible for as long as possible.

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

“There is no such thing as an ugly woman, only a man with a utter lack of imagination!” Anonymous

In a recent online article Grated listed it’s 10 most unattractive (ugly is an ugly word!) celebrities. After looking at the photos, we must admit that many on the list have been previously referred to during consultations here at Persky Sunder Facial Plastic Surgery by patients who, “…do not want to look like so and so!” We have undertaken the task of reviewing each of the listed celebrities photos, pointing out what exactly it is that has landed them on this unenviable list.

Before going any farther, let us remind ourselves that we are only refering to superficial, outer appearance, and that in the celebrity world there are many externally “beautiful” people not on this list who are “ugly to the bone” on the inside. Conversely, in defense of those on this list, yes, they may have made some bad plastic surgical physician choices in the past, but they may be beautiful people on the inside, where beauty really counts.

We must remember that it only takes millimeters of change one way or the other for the human primordial brain within fractions of a second to determine if a face is symmetric, healthy, and one that another human would wish to share genes with (reproduce) for survival of the species. When the millimeters of change are positive, it is rejuvenative and youthful. On the other hand, as in the case with many of the celebs on this list, when the millimeters of change are asymmetric, or measured in centimeters (or seemingly feet), then the unnatural change can cause the face to look like a genetic mutant (not to infer anything about the celebs on Grated’s top 10 list).

With that in mind and with tongue in cheek, here we go:

10. Melanie Griffith has had her share of bad plastic surgery and fillers over the years since she first met Miami Vice’s Don Johnson, but actually we feel that she is returning to normalacy (thank you Antonio Banderas), and most definitely there are other celebs out there more deserving to be on this list (see below). Melanie’s lips had been filled with something permanent, which created an imbalance, her upper lip being much larger than her lower lip. The proper lip proportions have the upper being smaller than the lower (upper lip should be ~70% the size of the lower lip).

9. Janice Dickinson has lips and breasts that enter the room a time zone ahead of the rest of her body. Other than her alien sized lips, her facial volume otherwise looks good for an older woman.

8. Jackie Stallone appears to have work done on her face by the same surgeon who worked on her son, Sly. Whenever it is obvious that someone has had plastic surgery, the surgeon has failed the patient (see the late Michael Jackson). Ms. Stallone has excessive lip volume, facial volume, elevated eyebrows which all add up to make her look like she is Carrot Top’s mother. By the way, Carrot Top’s plastic surgery is most deserving of a spot on this list.

7. Mickey Rourke has been a veteran of these lists for many years after having a premature, poorly performed facelift many years ago. Since then, boxing and multiple surgeries have changed Mickey’s appearance. His current appearance is actually becoming more normal, so this may be one of his final appearances on lists such as these, as long as he doesn’t go back to the same surgeon for a revision.

6. Male rocker Pete Burns has been transformed to a large “lips and cheeks on a stick” female look a like (see Housewives of Beverly Hills, he would fit right in). What is it about those lips? We are constantly having to reassure our prospective patients that it is not the injectable filler treatment that causes these abberations, but rather the injecting physician or nurse’s lack of artistic vision. By the way Pete, I hope that your coat is imitation, or that you are staying far away from PETA.

5. Cher is one of our favs and personally we don’t beleive that she belongs on this list. Cher has maintained her facial volume relatively well, and takes excellent care of her skin with non-invasive stimulating treatments. She would likely be a hugh fan of Ultherapy by Ulthera, lifting and tightening of the face, neck, and brows. “I’ve Got You Babe!”

4. David Gest may have the gold and platinum albums behind him, is worth multi-millions, but like his late friend Michael Jackson is the two word answer to a RealSelf.com question that we responded to a few years ago. The question was, “Do celebrities get better plastic surgery because they have more money?” Only the ones who choose their surgeons most carefully! Mr. Gest’s exaggerated elevation of his forehead and eyebrows, along with the feminizing upper eye lid blepharoplasty (can you say Bruce Jenner Kardashian?), the lower eyelid sceral show and ectropion from poorly performed blepharoplasty, and disproportionate volumization of his face have landed him most deservedly on this list of celebs.

3. Poor Donatella Versace, don’t know who she saw for her plastic surgery, but they have turned her into an aging Willie Mays (sorry Willie). Her facial volumization with fillers and/or fat is exactly what keeps many patients away from ever stepping inside a plastic surgeon’s office…”fat, pudgy face”.

2. Jodie Marsh. Not sure who she is, but what is again quite obvious is that she has had plastic surgery that is not in line with Leonardo da Vinci’s Devine Ratio of proportion. All that you can say about Jodie’s plastic surgery is that they tried their “breast”!

Drum roll please……..1. Iggy Pop (Really?) Mr. Pop is an example of where loss of facial volume and not dressing appropriately for one’s age will land you, as the winner of Grate’s Ugliest Person List! As we age, we lose facial volume, mainly fat and bone, but also some muscle. Before the days of filler and Ulthera, Catherine Deneuve said, “At a certain point in a woman’s life she must choose between her face or her fanny!” Fortunately today with fillers such as Sculptra, Radiesse, Juvederm, Restylane, and others, a woman (and aging rock stars) can remain slim but still maintain their facial volume.

Honorable Mention: Mick Jagger, the great front man of the Rolling Stones. See Iggy Pop above.

Be well!

Dr. Michael Persky and Dr. Sarmela Sunder are located in Encino, California and Beverly Hills, California (The Lasky Clinic) 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