Voluma Archives - Dr. Persky

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. 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: 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.

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

Points from the Video:

00:05- Patients are opting for non-surgical procedures;

00:28- Voluma is great filler and gives instant results;

Many patients are opting for non-surgical, non-invasive procedures today, not only because they don’t want the downtime that surgery entails, as well as the anaesthesia and other risks of the surgery, but the non-surgical devices and non-surgical treatments are becoming so much more effective. We have great fillers today such as voluma, which give an instant beautiful result and transformational result. We get the biggest wow from patients after they have had voluma; And there are other devices such as ulthera that lift and tighten the skin beautifully without surgery. Now there are still gonna be reasons for patients to have surgery but with the improvements of the non-invasive devices, many more patients are opting for non-surgical treatments.

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

Points from the Video:

00:10- He discusses about voluma which is hyaluronic acid filler;

00:35- He shares that one of the best things about voluma is that it lasts upto two years, and that it is used for long term correction in patients;

Voluma is hyaluronic acid filler and it has been formulated with cross-linking technology that makes it last longer than any other hyaluronic acid fillers. The other hyaluronic acid fillers include juvederm, restylane, and perlane, and those last from six-nine months. One of the great things about voluma is that it lasts up to two years, so we are able to put it in areas and know that there is going to be a long term correction in patients.

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

Points from the Video:

00: 11- He discusses how voluma is incomparable to any other filler;

00:20- He shares the results that voluma can deliver;

The most exciting thing about voluma for us is that there is no comparable filler. We have other hyaluronic acid fillers but they just don’t last as long and they don’t have the strength of spring of lifting. In other words, you can place voluma up in the cheeks laterally over the zygomatic arch, and you can get improvement under the eyes, in the nasal labial folds, in the lower cheek, and in the fine lines of the cheek. In some patients, you could even get improvement in the jaw line. There is no other filler that we have available that can do all those things, and then, last so long. For us, voluma has been a real game changer, and our patients really appreciate it. And there is no other filler that we use; After the treatment, we hand over the mirror to the patient, and there’s always that wow, with voluma; It’s a pretty amazing product.

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

Points from the Video:

00:15- He talks about how voluma can be used off-label;

00:40- He advises patients to choose their injecting physician most carefully;

Voluma can be used off-label, which means not FDA approved, or approved by the company in the label that comes with the product; It can be used off-label in many areas. People are using it in their jaw-line and their chin; Some are diluting it and using it in the lips and other areas of the face. So, yes it can be used in other areas but with great caution. As with all aesthetic procedures, I advise patients that they really have to choose their injecting physician most carefully to ensure the best results and to avoid that funny overdone look.

“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.

When You Look Marvelous… Millennials, Botox, and Natural Beauty

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