As Nora Ephron’s popular book title, “I Feel Bad About My Neck” expresses, many of our patients share her feelings about their own necks.  At some time in their late 30’s and early 40’s patients often notice changes in their neck, usually not for the good! nora ephron

 

Neck skin begins to appear saggy and crepe while the (playsma) muscle bands become prominent even when not actively clinching our neck muscles.  In most young patients it is premature to immediately jump to neck lifting surgery to correct these early signs of the aging neck.

 

Fortunately, we have a few quick, safe, and effective non-invasive, non-surgical treatments to restore a youthful neck.   These treatments include Radiesse hyper-dilute injections, Ultherapy, Profound RF (Radio-frequency), light CO2 laser, and Medi-Inject.

 

Radiesse is a biological stimulatory filler which mean once it is injected, your body reacts to it by making more of your own collagen where it was placed.  Research has shown that mixing Radiesse 1:4 with lidocaine and saline results in the perfect mix to stimulate collagen in the neck resulting in immediate noticeable improvement of crepiness and horizontal “rings” of aging in the neck.  Adding heat from a device (either Ultherapy or Profound Radiofrequency with microneedles) multiplies the effects of the previous hyper-dilute Radiesse injections.  In select patients we add a very light CO2 laser superficially, and in others we add a customized “cocktail” injection with Medi-Inject.  Medi-Injectis an automated injection system that precisely injects a cocktail of PRP, hyaluronic acid filler, Botox, and other ingredients in the epidermis resulting in fresh vibrant skin.  Vitamins, skin lighteners, and even stem cells can be injected with Medi-Inject.

 

It is wonderful that technology and technological advancements have progressed to the point where we are able to address our patients concerns about their aging neck with non-invasive, non-surgical solutions so that they no longer have to feel bad about their necks.  We offer surgical options as well for patients where surgery is indicated.

 

Please feel free to contact our office with any questions or concerns regarding your neck.  Stay well.

 

Dr. Persky

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

Points from the Video:

00:05- Ulthera is micro-focused ultrasound treatment;

00:50- The second aspect of the ultrasound technology;

01:13- We control very small one millimeter hot area beneath the surface of the skin;

01:29- There are contraction and lifting after the ulthera procedure;

Ulthera is micro-focused ultrasound treatment and what that means is that with the ultrasound technology, we are able to see the levels of the skin that we want to lift and tighten. It is the only FDA approved lifting, tightening treatment for skin of the face and neck, and the eye brows, and it’s just recently been approved for the treatment of the décolleté. With ulthera, we are able to visualize the levels of the skin with an ultrasound screen and then, the second aspect of the ultrasound technology is that it emits ultrasound waves that meet at a point, and ultrasound waves when meet at a point, similar to sun rays that are condensed to a point by a magnifying glass become very hot; So, we are able to control a very small one millimetre hot area beneath the surface of the skin without affecting the other areas of the skin. This creates a micro burn which overtime heals and forms a lot of collagen. There is some immediate contraction and lifting after the ulthera procedure, but it’s really overtime; What we have seen over 6-9 months is continued improvement and rejuvenation of patient’s faces, necks and around the eye area.

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:

00:13- Patients in sixties/seventies coming in for ultherapy;

00:40- Ultherapy is actually good for older patients;

01:00- Ultherapy works great for all patients between age of 30-80;

Another great group of ultherapy patients are those who are 50 years or older who really don’t want to have surgery. We have had patients coming in to our office in their sixties and even seventies who had a fear in coming up and saying that it was their daughter’s wedding or something like that; The mother of the bride really didn’t want to undergo surgery and we discouraged her from the treatment initially, we said you really need a face or a necklift for this; and she said, no way, I just wanna look better for the wedding. That’s how we first learnt that ultherapy is actually good for patients who are older and may need a facelift but may not really want to have a surgery. She had an excellent result on her face, and still had a little laxity on the neck, but overall, she was very pleased with the results. So I think you can treat patients anywhere between the age of 30-80 with ultherapy and see results. The important thing is setting realistic expectations of what to expect from the treatment, and we do that with all our patients’ consultations.

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- Avoid aspirin, advil, motrin prior to ultherapy;

00: 40- We offer a local anaesthetic;

One of the nicest things about ultherapy is that it’s so easy to do. There is no preparation for the procedure. For surgical procedures, I just prepare patients by telling them not to take any aspirin, advil, motrin or other things that thin the blood prior to surgery. With ultherapy, because it’s totally non-invasive, patients can just walk in the office and just have the treatment done. Ultherapy can be a little discomforting during the treatment, so we do offer patients a local anaesthetic. In those patients, we are going to put a few injections of local anaesthetic, we do ask them to avoid taking anything that might thin their blood about 5-7 days prior to the treatment.

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: 05- There might be some swelling after ultherapy;

00: 29- Maintain normal social activities immediately after treatment;

Occasionally, patients will have some swelling around the jaw line and in the middle of the lower neck under the chin. If there is swelling, it may last for a day or two but it’s usually gone. I personally had ultherapy and was able to go out to dinner and maintain normal social activities immediately after the treatment. So for the most part, there is really no downtime with ultherapy.

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: 05- Time taken by ultherapy depends on areas treated- cheeks, face, upper neck;

Ultherapy treatment usually takes anywhere from 45 minutes to two hours depending on the areas we are treating. If we just treat a single area, say the cheeks that might take a half hour-45 minutes to treat an entire face, and upper neck takes about an hour and ten minutes, and if we are gonna treat the entire face, upper neck, lower neck, which we call an extended neck, that may take up to two hours. So the treatment time varies depending on the areas we are treating. To treat the décolleté, that takes about 30 minutes.

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: 06- Ultherapy works, and ultherapy hurts;

00: 25- A single pulse of ultherapy is like an electrical jolt;

01: 15- Xanax and Demerol to relax and relieve pain;

One of the sayings about ultherapy really on is ultherapy works, but yes, ultherapy hurts. Today, particularly in our practice, Persky Sunder Facial Plastic Surgery, we are very concerned about a patient’s comfort; If you feel a single pulse of ultherapy, it feels like a bit of an electrical jolt for a few seconds like a little fine height needle. It’s very tolerable if you have 1, 10, or 20 of those pulses. During the course of ultherapy treatment, we may give from a 500-1000 of those pulses. So what I usually recommend for our patients because I want them to be as comfortable as possible is to allow us to put in a little bit of local anaesthesia which makes the treatment very-very easy. There are some patients who have a higher tolerance for pain and don’t want local anaesthesia and they tolerate the procedure well, as well without anything, and then there are some patients who don’t want to feel a thing, and for those patients, we ask them to have someone drive them to the office and we give them xanax to relax them, and then, we also give them a weight proportional dose of Demerol which is a narcotic pain reliever, even though they may feel a little something, they feel so good from the Demerol that it doesn’t bother them and they get through the procedure with flying colors.

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:

00:05- How ultherapy is different from other non-invasive technologies;

00:25- Ultrasound picture in ultherapy;

Ultherapy is different from all other non-invasive technologies; In that, we are able to visualize the area of treatment as we are doing it live. So, we place the ultherapy transducer hand-piece onto the skin, onto the area we are treating, and we can see live an ultrasound picture of the skin, just like we see the ultrasound pictures of the babies. We are able to see the level of skin, the level of fat, and the level of muscle lining. We target the muscle lining in the under surface of the skin, and we try to avoid fat. So, what makes it so different is we are able to target the area actively, based on the patient’s anatomy, and know what exactly we are treating with this non-invasive technology. The other thing that makes it different from all other technologies is that it is ultrasound based, and not laser based.

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:

00:05- 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.

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