Sculptra Archives - Dr. Persky

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

Points from the Video:

00: 08- One of the nicest things about all the new facial fillers that we have is that you can pick and choose what’s right for each patient;

00:38- In medical terms, we talk about G-prime. G-prime is how much a product can actually lift;

00:45- We use some of our thicker products in our older patients, such as radiesse, voluma;

00:55- I like to use juvederm, restylane, bella terra, sculptra, and even voluma because it is injected so deep in younger patients;

The injecting physician should be like an artist, at least have an artist’s palette before them, and one of the nicest things about all the new facial fillers that we have is that you can pick and choose what’s right for each patient. With older patients, because there’s a lot of laxity and more need for volume in lifting, we need a product that has more robust lifting ability; it’s a little bit thicker. In medical terms, we talk about G-prime. G-prime is how much a product can actually lift. So we use some of our thicker products in our older patients, such as radiesse, voluma, whereas with younger patients, you don’t want something that is as heavy and that might show through. So I like to use juvederm, restylane, bella terra, sculptra, and even voluma because it is injected so deep in younger patients. If you have any questions about any of these fillers, feel free to call me or contact us.

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

Points from the Video:

00: 20- Both of these procedures create small little pores in the skin through which substances can be applied;

00:36- What we found is that sculptra is the collagen stimulator;

01:09- So, this is an exciting new application of topical treatments that can penetrate deeper into the skin;

One of the most interesting recent studies that we have seen deals with rubbing sculptra topically after the skin has been treated either with the fractionated carbon dioxide laser or with micro needling. Both of these procedures create small little pores in the skin through which substances can be applied, and they get down deeper into the skin because of their effect. What we found is that sculptra is the collagen stimulator, so by putting particles of sculptra on these wounds, we are finding that there are better results ultimately with the patients, particularly when treating the chest and other areas- the neck. We are also seeing that with micro needling, other substances that help the skin can be applied as well, such as vitamin E or retinoids. So, this is an exciting new application of topical treatments that can penetrate deeper into the skin after the skin has been traumatised with either laser or micro needling.

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.

Mary: Is that… is that hair gel? From “There’s Something About Mary“

We have just returned from Phoenix, Arizona this weekend where the Sculptra Aesthetic Training and Education Relaunch Advisory Board was held. About 20 of the world’s top Sculptra injectors met to discuss their vast experience with the use of Sculptra. We were humbled and honored to be included with these brilliant, creative, artistic aesthetic physicians.

oxman sculptra Sculptra (Galderma; Dallas, TX a subsidary of Nestle; Vivey, Switzerland) is Poly-L Lactic Acid (PLLA), the same material that make up absorbable sutures. Sculptra has been used since 1999, was first FDA approved to stimulate volume in patients with HIV lipodystrophy in 2001 in the US. It was approved for cosmetic use in the US in 2004. Sculptra is safe, effective, and has many benefits.

We have found the use of Sculptra to be among the best values of facial rejuvenation because of it’s long lasting nature as well as the ability to treat the entire face. Though Sculptra is used in patient of all ages, it is best to begin Sculptra treatments in young patients as less is needed and the aesthetic benefits are quickly seen. Our faces begin to lose volume (bone and fat) from about 25 years old on. A vial of Sculptra properly placed can reverse the earliest signs of facial aging…mid-face hollowing, hints of jowls, and sagging jaw line.

Sculptra patients look younger. Among the best candidates for Sculptra are athletic wasted faces, post-face lift patients, and patients 45 years old or younger with mid face volume loss, especially men. Sculptra is a unique product in that it provides both lifting and tightening of the face and neck. It not only stimulates mcrae sculptra increased volume in the face, but there is a “Sculptra Glow” of the skin. With Sculptra patients get the benefits of many products combined resulting in improved facial structure and skin improvement. In thin skinned patients with dynamic smile/sleep lines on the sides of their face/cheeks, Sculptra can correct these difficult to treat lines and improve the quality of the skin long term.

Along with improved general skin quality, Sculptra most impressively corrects acne scars. It is also being used to improve the skin and lines of the decollette` and to rejuvenate hands. It is being applied topically after fractionated CO2 laser treatment to markedly improve laser results. We have found that patient results with Sculptra are greater when the patient commits to an excellent skin care product regime during and after their treatment.

The key differentiator of Sculptra is that it stimulates the patient’s own collagen production resulting in natural volume replacement. It is also unique Sculptra male in that the effects of Sculptra occur gradually over weeks to months, and then the results are the longest of any non-permanent facial filler. It is also the only facial volume injectable that heat devices such as Ulthera and lasers can be used over. In fact, we have found that the effects of each of these treatments are exponentially increased when used together!

Sculptra is well suited to allow those of us expert in facial evaluation and aesthetics to use our artistic vision treat the whole face and attain natural beautiful results for our patients.

An article in JAMA Facial Plastic Surgery Jan/Feb 2015 by HH Chen, et.al. has documented the quantitative effectiveness of Sculptra over a long time period. The incidence of complications and adverse events with Sculptra are minimal because of the knowledge and experience of it’s use over the years.

There is “something about Sculptra” that has made it one of the best choices for both men and women of all ages to look younger and improve the long term quality of their skin. Should you have any questions about Sculptra please feel free to contact us. Be well!

An article on Nov. 12, 2014 in MStars News, entitled “Mary Kate Olsen: Plastic Surgery or Pregnancy? What Happened To The Child Star’s Face?” asks what we think Mary Kate Olsen has done to appear so different from her identical twin sister Ashely Olsen. It is obvious that Mary Kate has received facial filler treatment that has not been “identically” received by Ashley.

When one twin drastically appears different from the other, it is rather easy to compare and contrast the differences in their faces. This photo shows the obvious filler in Mary Kate’s lips, her cheeks, temples, forehead, and jawline resulting in a more masculine appearance than her twin sister. The most likely filler used, in my opinion, is Voluma, a great deal of Voluma. In a 28 year old woman, we may use 1-2 syringes of Voluma for subtle volumization of the cheeks. To create the changes seen in Ms. Olsen, 28 years old, would likely take at least 6 to 10 syringes of Voluma. Other fillers were likely used including Juevederm in her lips, and perhaps Sculptra in her face.

The MStars article postulates that Mary Kate’s facial changes may be due to pregnancy. Though pregnancy can add volume to the face, it does not add it in the manner Ms. Olsen’s face has changed.

Ironically, for all of the “rejuvenation” work that Mary Kate has had done, she now appears at least 10 years older than her twin. We have seen this time and again when young patients receive excess filler. They look much older, and the same physicians that create this look, use the fillers in a similar manner attempting to make 50 and 60 year old women appear 40-ish. In my opinion, Mary Kate now looks like an older woman who is trying to look younger.

So, what happens when one twin has aggressive facial volumization and the other does not? Well, the obvious plastic surgery changes are more obvious, but at least for someone who has difficulty for 25 years telling them apart, I can finally differentiate Ashley from Mary Kate. Choose your facial plastic surgeon most carefully, based on their skill, experience, and most importantly, their natural artistic vision. Be well.

Read more: http://www.mstarz.com/articles/41806/20141112/mary-kate-olsen-plastic-surgery-or-pregnancy-what-happened-to-the-child-stars-face-photos.htm#ixzz3J11aJRKZasks what has Mary Kate Olsen done to her face

If you are interested in Facial Injectables, please schedule your consultation with Dr. Persky by calling (818) 918-9252. Join our newsletter to receive special offers & promotions exclusively available for subscribers.

“At Some Point in Every Woman’s Life She Must Choose Between Her Face or Fanny”

Catherine Deneuve

The most revolutionary concept in facial plastic surgery over the past 10 years is the appreciation that replacing volume in the face is rejuvenating. The most exciting fillers that we are using to sculpt and restore natural facial volume are Voluma and Sculptra. In December 2013 Voluma was FDA approved for restoring volume of the cheeks, lasting up to 2 years. For the past 4 years we have loved using Sculptra to restore volume and the heart shaped face of youth. Once full facial correction is reached with Sculptra, the effects last up to 2 to 4 years until maintenance is needed.

Patients are now asking, “What’s better Voluma or Sculptra?” Fortunately, they are both great. In the past few months since Voluma was introduced to the US market, we have been combining it with Sculptra. Voluma is excellent for immediately restoring cheek volume. By lifting the cheeks naturally, it is amazing how the lower eye tear tough hollow, the nasolabial folds, lower cheek lines, and even the jowls are improved. Voluma injections are relatively easy, quick, and comfortable. There is local anesthesia mixed in the Voluma syringe, and we use ice to distract the brain from sensing the injections. Patients wash their face with anti-bacterial soap prior to treatment. One to two syringes are most commonly used at the first visit. Immediate results are seen. There can be swelling for 1 to 3 days, and a minority of patients may have bruising for a few days. We see our patients about 10 to 14 days after their treatment for a face check, post-photos, and possible additional treatment.

Voluma can be used “off label” in other areas of the face but we prefer to use Sculptra in the rest of the face (Sculptra’s only on label use is for treatment of the naso-labial folds.) The amount of volume added with Sculptra is directly related to the number of injection sessions. Sculptra results are gradual over time, maintaining a natural appearance for our patients. Most patients receive 2

6 Months After Multiple Sculptra Sessions by Dr. Persky

vials of Sculptra at their first treatment. They are then seen 6 weeks later for photos and further treatment if needed. Once the patient reaches complete correction they are advised to return for maintenance Sculptra whenever they desire, usually between 1 to 4 years.

For patients who wish the ultimate in non-invasive, non-surgical facial and neck rejuvenation, we combine the use of Ultherapy, the only FDA approved for lifting and tightening the face, eyebrows, and neck (a micro-focused ultra-sound technology) with Voluma and/or Sculptra. In summary, it is wonderful to add a new revolutionary injectable product (Voluma) to the tried and true, safe and effective injectables we have used over the years.

voluma-before-and-after-2 The most important aspect of any facial aesthetic treatment is choosing your physician most carefully based on their artistic vision, skill, and experience to insure your best natural cosmetic results in the safest manner. Please feel free to contact us with any aesthestic questions that you or your friends and family may have. We look forward to the privilege of helping you achieve and maintain your facial aesthetic goals. Be well.

Dr. Persky treating patient

“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.

The recent issue of Allure Magazine discusses the 11 most overrated cosmetic procedures. As the title would indicate, we don’t perform most of these procedures, we do use some of the treatments, but definitely have our opinions on all of them. So here we go:

1. Foot Lifts…this can vary from surgical intervention to make feet fit better into pointy shoes, shortening of a long second toe, and even lipo for a little toe that is too fat! The treatment that we are most asked about is the injection of hyaluronic acid to add padding to the balls of the feet (dubbed the “Loub job,” after Christian Louboutin). We do not perform any of these procedures, the risks and complications are not worth the small benefits of the treatments.

2. The “Vampire Lift”…involves drawing blood from a patient and then re-injecting plasma (the yellow fluid) from the blood into wrinkles around the eyes and lips. The problem with the procedure is that it has not proven to be effective, does not last, is not FDA approved, and adds about $1,000 to your filler injection bill. Kim Kardashian had a variant of this when she had her own plasma applied to her face after having had a dermapen treatment (it makes small pin pricks into the skin). We are not fans of the Vampire Lift.

3. Smart Lipo…is effective when performed properly. It uses a laser fiber to assist in liposuction of the body. There is an increased risk of skin burns and scars with the treatment. It is one of the best treatments that I have seen for loose upper arms in women. We do not perform body liposuction, and have found that standard liposuction of the neck is as effective without the risks and complications.

4. Stem Cell Facelift… is quite the rage, most surgeons believe it is more hype than substance. Almost immediately, surgeons began to claim—with no proof—that the stem cells in fat improved skin quality and starthttps://www.drpersky.com/ed calling fat injections a stem-cell face-lift, says Rod J. Rohrich, MD chair of plastic surgery at the University of Texas, Southwestern, in Dallas, and the coauthor of a recent paper on the subject. But the idea that fat injections could replace a traditional face-lift is “high on marketing and short on science,” Rohrich says. “Stem cells have great promise, but there is so much conjecture.” We have believed that the stem cells present in fat transfer procedures are responsible for some of the incredible improvement of the overlying skin, but doubt the added benefit of concentrated these stem cells and calling it a stem cell lift.

5. Artefill and Sculptra for Lips…should never be used. Lip tissue is delicate, Artefill is a permanent mixture of Plexiglas-like beads and cow collagen, is approved only for filling smile lines. We do not use Artefill. Sculptra is a wonderful facial volume rejuvenation treatment, but should not be used close to or in the lips.

6. Silicone Cheek Implants…The news for women who want to add volume to their cheeks is good: Facial fillers have all but replaced the silicone implants that were standard in the ’90s. I am not a big fan of permanent cheek implants as they remain static as the face changes over time, often causing a “funny looking” result (see Barry Manilow, Dionne Warwick, etc.). I much prefer using injectable fillers such as Sculptra and Radiesse to augment cheeks.

Before and After Ultherapy (Author)

7. Ulthera…is one of our favorite and most popular and effective procedures. The reason that Ulthera made this list is because so many practitioners are unable to control the discomfort of the procedure for their patients. We have by the judicious and strategic use of local anesthesia. After more than 250,000 worldwide treatments over the past 3 years, Ulthera remains the best non-surgical lifting and tightening tool for the face, neck, and eyebrows at our disposal!

8. Fat Injections for Breast Augmentation…There’s a good reason “fat injection” is the latest catchphrase in cosmetic breast augmentation. The results look good and feel natural, and unlike a scalpel, the needles leave no scars. But there are often downsides. Multiple procedures may be necessary and, with few exceptions, provide, at most, a one-cup-size enlargement. A study by Mihye Choi, an assistant professor of plastic surgery at NYU School of Medicine, found that half the volume created by shots of fat disappears into the body within months. More worrisome, there is concern that, years later, stem cells in the fat might stimulate cancer. We limit our treatments to the face.

9. Brachioplasty…is surgical treatment of the upper arms. The problem is that no one likes the scars that result, defeating the goal of the treatment, being able to again wear sleeveless clothes.

10. Butt Implantsare being replaced by fat transfer due to the lack of a natural pocket and the high complication and re-operation rate.

11. Zerona Fat Melting Laser…only melts your hard earned dollars from you wallet. The super market bar code reading laser cannot penetrate through the skin to cause the effects that are claimed by the company. The studies only measure patients results for two weeks after the treatment, and patients must take a dietary supplement, Curva to get the “results”. Zerona truly deserves to be on this list, probably at the top.

We are constantly evaluating new techniques, products, devices, and procedures. Unfortunately in the “business ” of aesthetics it is often difficult to distinguish the hype from what’s real. Other than Ulthera and SmartLipo, the Allure article has successfully done that for the public. Please feel free to contact us with questions or concerns that you may have regarding facial aesthetics. 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

“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!

Getting the Right Filler for Your Age, Los Angeles, CA

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