Ulthera Archives - Dr. Persky

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:

00:05- The safety factor of ultherapy;

00:25- The nerve weakness that some patients might feel;

One of the nicest aspects of ultherapy is its safety. Over the last four years, the worst thing that we have seen in a patient has been a little bit of swelling; Occasionally, there could be a little bruise. Some of the worst reported side effects of ultherapy have to do with a little bit of nerve weakness at the corner of the mouth that usually the patient can sense, but no one else can see. In all such cases, the nerve weakness has resolved within three weeks. So one of the nicest things for physicians performing ultherapy is a great safety factor that we can treat the patients; They are not going to suffer any serious side effects.

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:

00:05- People often ask how long ultherapy would last;

00:25- How ultherapy always makes the patient look better;

01:05- The reasons for patients coming back for ultherapy;

One of the questions that patients always ask us at the ultherapy consultation is ‘how long will my ultherapy treatment last?’ Patients would always look better than they would have for the rest of their life, had they not had the treatment. So, by having the treatment, you are always going to look better than you would have, had you not had it. Now, patients age differently after any type of treatment, so it is hard to put exact number on exact amount of time on how long ultherapy will last, unlike botox or fillers that last for a certain amount of time. But what we have been finding over the last four years in treating patients is that most patients have had just one treatment and still, it looked better than before they started the treatment. Patients that do come back for a second treatment usually come back anywhere from 1-3 years later, and they are coming back because they like the effect and want more. So, it looks like ultherapy is lasting a lot longer than we thought initially when it first came out. Now doctors say ‘I recommend my patients to come back two years to have another ultherapy treatment’. But it’s really based on the individual and what they want; Ultherapy is just a tool that helps to lift and tighten, and we have some patients who have the means and the time, and they have had two or three of them done every 6 months and they look incredibly great. So how long it lasts really depends on many factors but we are finding that it is lasting a lot longer than we thought.

“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.

Video Highlights

0:06 Can ulthera pain be reduced?
0:15 What is ulthera?
0:31 Common patient concern about ulthera treatment
0:38 Managing ulthera pain
0:48 Persky-Sunder ulthera technique
1:07 Strategic use of anesthesia
1:21 Feedback from clients
1:56 Ulthera pain is manageable
2:16 Call us for consultation

Hi, this is Dr Michael Persky from Encino California or as we like to call it here, the Beverly Hills of the San Fernando Valley. Today I’d like to talk to you about easing the pain during your Ulthera treatment.

Ulthera is the only FDA Approved non-invasive device that’s been approved for lifting, and tightening of the neck, face, and eyebrows. It’s a very effective treatment but the big thing that we hear from patients is they’re worried about the pain of the treatment. Certainly other practitioners who call us about Ulthera are also concerned about managing the pain of the treatment.

Over the past 3 years, we as facial plastic surgeons at Persky-Sunder Facial Plastic Surgery have developed techniques that make the ulthera treatment quite comfortable for our patients. As facial plastic surgeons,

we know the nerve distribution of the face and neck and are able to use small amount of strategically placed local anesthetic to make it a very comfortable procedure for patients.

In fact just yesterday, I received a very nice email which you can see on my blog at drpersky.com

The patient had her Ulthera treatment, extended neck treatment from the corner angle of her jaw to her clavicles to lift and tighten the neck and clean up the jaw line. She had it two days ago and wrote saying she couldn’t believe how relatively painless the procedure was. Even the injections she said she felt that we were injecting her in areas that are already numb.
So, Ulthera doesn’t necessarily have to be a painful procedure to get very very good results. We do perform all of our own anesthetic and treatments here.

If you have any concerns about Ulthera, any questions about it or the comfort levels during the treatment, feel free to call us and we’ll be happy to get back to you. Be well, Bye bye.

As an international lecturer and instructor for Ultherapy by Ulthera, I often hear questions about the pain of Ulthera, “Ulthera is the best lifting and tightening non-surgical treatment for the face and neck, but it is so painful!”, or “But Dr. Persky, how do you manage the pain?”. We are dedicated to keeping our Ulthera patients as comfortable and pain free as possible. Over the past 3 years we have developed techniques that make Ulthera most effective and very tolerable (even in patients with a low pain threshold). Both Dr. Sunder and I are facial plastic surgeons with full knowledge of facial and neck anatomy along with the nerves that can be blocked with a small amount of local anesthesia. Our Ulthera treatments are performed by physicians only.

Today we received these kind words from a patient whom we treated with an extended neck Ulthera treatment just two days ago:

Hi Dr. Persky,

I just wanted to thank you for the terrific treatment on Tuesday. The pain control was spectacular as it seemed you injected me in areas that were already numbed. I have a few small areas of bruising but nothing serious.

The great news is that there is already a marked improvement along the jawline, which is of course what we wanted. I am amazed and excited to see such improvement already.

Thank you also for taking your time and really giving me such a thorough treatment. I am very grateful.

Hope to see you next year 🙂

Aloha and mahalo,
(Name deleted)

Don’t let the fear of pain keep you from looking your best. We understand your concerns and treat you as we would want to be treated ourselves. Be well!

Actress Courteney Cox, 49 years old, appears more beautiful now that she did ten years ago. What is her secret to looking amazingly youthful and beautiful. In a recent NEW YOU Magazine article interview, Ms. Cox was very candid in sharing her beauty treatments.

At the recently completed Vegas Cosmetic Surgery 2013 meeting, the consensus was that beauty is about having a “natural”, unoperated upon look. Chicago facial plastic surgeon and colleague Steven Dayan, MD in his New York Times Best Seller List book, “Subliminally Exposed” emphasizes that by correcting subtle signs of aging, patients can look naturally more beautiful, creating more self-esteem.

Ms. Cox is the “poster girl” for how those millimeters of change make years of difference in appearance. She is also one of the few Hollywood stars who is willing to admit that she has Botox treatments. To the question, “What else have you tried?”, she answered, “I am a big laser believer. I really think they are the wave of the future. I just did Ulthera (not a laser but an ultrasound treatment that Dr. Persky lectured on in Vegas this week), which is supposed to produce collagen. And I’m about to do Fraxel (Dr. Persky and Dr. Sunder are Fraxel experts), which will get rid of all these brown spots on my arms, chest, and face.”

Thank you, Courteney Cox. You look great!

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!

The Four Most Popular Men’s Facial Aesthetic Treatments

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