Dec
7
De-wrinkle Yourself
Filed Under Aesthetic Procedures, Aesthetic medicine, Beauty Tips, Plastic Surgery, Skincare | Leave a Comment
We’ve all heard the clichés: Wrinkles are a roadmap of your life. But many of us would rather not be reminded of the distance we’ve traveled. What can you do? First, understand what causes wrinkles. Then, if you still want to reduce wrinkles, explore your treatment options.
What Causes Wrinkles?
The following factors are the most significant:
Aging
Wrinkles are a by-product of the aging process. With age, skin cells divide more slowly, and the inner layer, called the dermis, begins to thin. The network of elastin (the protein which causes skin to stretch) and collagen fibers (the major structural proteins in the skin), which support the outer layer, loosen and unravel, causing depressions on the surface. With aging, skin also loses its elasticity, is less able to retain moisture, oil-secreting glands are less efficient and the skin is slower to heal. All of these contribute to the development of wrinkles.
Facial Muscle Contractions
Lines between the eyebrows (frown lines) and lines jutting from the corner of the eyes (crows feet) are believed to develop because of small muscle contractions. Smiling, frowning, squinting and other habitual facial expressions cause these wrinkles to become more prominent. Over time, the expressions coupled with gravity contribute to the formation of jowls and drooping eyelids.
Sun Damage
Exposure to ultraviolet radiation (too much sun) can result in premature aging of skin. Premature aging of the skin is called photoaging. The ultraviolet sunrays that cause photoaging damage collagen fibers and cause the excessive production of abnormal elastin. When ultraviolet light damages skin tissue, an enzyme called metalloproteinase is produced. This enzyme creates and reforms collagen. During the process, however, some healthy collagen fibers are damaged, resulting in a disorganized formation of fibers called solar scars. Wrinkles develop when the rebuilding process occurs over and over.
Smoking
Healthy skin perpetually regenerates. While old collagen is broken down and removed new collagen is produced. Researchers have found that smoke causes a marked reduction in the production of new collagen. A lack of new collagen results in the development of wrinkles.
What Are the Treatment Options for Wrinkles?
There are numerous over-the-counter treatment options for wrinkles, including various creams and lotions. Prescription treatments, including the retinoid cream renova, are also an option.
Removing skin layers to reduce wrinkles or irregular depressions is an effective way to regain smoother, more youthful looking skin. Dermabrasion (scraping layers away) and chemical peels (dissolving skin away) are two of the traditional methods used in skin resurfacing. Laser skin resurfacing with an ablative laser (such as an erbium or carbon dioxide laser) is another technique that, like dermabrasion and deeper chemical peels, may require some downtime during the healing process.
Other lasers, known as non-ablative lasers, may also be beneficial in treating wrinkles. These lasers work by heating the dermis and stimulating collagen growth. This process, which leaves the outer layers of skin intact, has no downtime associated with it. However, the results are not as dramatic as the ablative lasers which actually remove the surface layers of skin.
Botox collagen and other injections are the addional techniques available to help minimize wrinkles.
If you are considering treatment for your wrinkles, ask your doctor which procedure is right for you. There is no replacement for your doctor’s professional advice. Each person has his or her own individual needs; similarly, each procedure fulfills its own specific need.
Taken from WebMD, Reviewed by the doctors at The Cleveland Clinic, Department of Dermatology.
Oct
1
Teens and Plastic Surgery: An Expert Interview With Michael F. McGuire, MD, President-Elect of the American Society of Plastic Surgeons
Filed Under Beauty, Plastic Surgery | 1 Comment
Editor’s Note:
Having cosmetic surgery is a growing practice among teens. There is general debate about the appropriateness of cosmetic surgery in teens and whether they truly understand the risks involved. Medscape’s Pippa Wysong spoke with Michael F. McGuire, MD, President-Elect of the American Society of Plastic Surgeons (ASPS). He was a member of the team that authored the ASPS guidelines on cosmetic surgery in teens. Dr. McGuire is Associate Clinical Professor of Surgery at the David Geffen School of Medicine at University of California at Los Angeles (UCLA), Chief of Plastic Surgery at St. John’s Health Center in Santa Monica, California, and is board certified by the American Board of Plastic Surgery.
Medscape: Today we’re talking about plastic and cosmetic surgery in teens. Could you start by describing the main types of plastic surgery preformed?
Dr. McGuire: There are 2 basic reasons for performing plastic surgery in children and teens. The first, reconstructive surgery, is aimed at repairing defects that impair normal function. The other, cosmetic surgery, has more to do with improving confidence and self-esteem. We also perform reconstructive plastic surgery in newborns — for example, cleft lip and repairs of various severe birth defects.
Medscape: The popularity of cosmetic surgery in teens is increasing. Why is that?
Dr. McGuire: Plastic surgery is becoming more acceptable in the population in general. More teenagers are having it done. Parents are more accepting of it and are more sensitive to the role that appearance plays in self-image and confidence in teens.
Medscape: Which cosmetic procedures are the most popular?
Dr. McGuire: In the younger middle teenage years, the most common surgical procedure in both young women and men is rhinoplasty. Nasal surgery should be performed after the nose is fully grown, which is generally about age 14 in girls and 15 in boys.
Medscape: Which other procedures are common in teens?
Dr. McGuire: Breast reduction is relatively common. Some young girls develop overly large breasts, hypertrophy, at a young age. This procedure is also increasingly common in boys too (gynecomastia), with over 14,000 operations performed on boys aged 13-19 in 2008. On the other hand, some young women want breast enlargement because they want to have normal-sized breasts that are harmonious with their body. Then there are young women whose breasts grow to be noticeably different sizes, and so surgery is done to make the 2 sides equal.
Otoplasty (ear surgery) is a common procedure for kids around 6 years of age who are teased mercilessly by their peers.
Medscape: Surgery is a permanent thing; are teens mature enough to really understand that?
Dr. McGuire: In some cases, yes, and in some cases, no. It’s not only about their chronologic age but also their emotional age. Some teens are very emotionally mature, whereas some 25-year-olds are not. If a teen is emotionally mature and presents himself or herself as understanding what’s involved, why they’re doing this, and has realistic expectations, then it’s appropriate. But if a 12-year-old comes in wanting rhinoplasty and is unusually emotionally mature, it would still be inappropriate to do the surgery because her nose has not grown fully.
Medscape: Do teens really understand the permanence of procedures?
Dr. McGuire: There is the permanence of a procedure plus the risks of the surgery and having realistic expectations. It all has to be discussed carefully. One job of plastic surgeons is to detect unrealistic expectations.
Medscape: Are there guidelines or instruments available to help plastic surgeons with the psychological assessment of patients?
Dr. McGuire: It’s something that you learn during residency while watching your mentors evaluate patients. When you evaluate a patient, it’s not just the physical examination; it’s also an assessment of patients’ emotional and mental health and stability. Plus, the consultation is a 2-way street: The patient assesses the surgeon to determine whether the surgeon is competent, caring, and appropriate for them, and the surgeon assesses the patient for appropriateness for the surgery.
Medscape: If one surgeon decides that a teenager is not appropriate for surgery, can’t that patient just keep shopping around until she finds a surgeon that will do the job?
Dr. McGuire: Absolutely. When you have a patient who isn’t appropriate for surgery you don’t say, “Get out of here, you’re nuts,” or “You’re not appropriate.” Surgeons are obliged to do an educational session with that patient to explain why this is either not the right time or they’re not a good candidate. It’s a matter of educating the patient and cautioning them not to go to unscrupulous, untrained people who call themselves plastic surgeons who would perform the procedure anyway. Patients should look for an ASPS-member surgeon who is board certified in plastic surgery.
Medscape: Are surgeons actually taking the time to talk to young patients?
Dr. McGuire: If they’re not, they shouldn’t be doing surgery. There is much more to surgery than making incisions. You’ll get into all kinds of problems if you don’t properly evaluate the patient ahead of time. Patients should note that the so-called “free” consults with a nurse are not adequate; the surgeon must be involved.
Medscape: Should the number or type of cosmetic procedures that are available to teens be limited?
Dr. McGuire: Some types of procedures simply are not appropriate. For instance, we generally don’t perform breast implants until at least 18 years of age, and silicone implants can’t be done until patients are age 22. It’s unusual to perform breast reduction before age 15. An exception may be made for young patients with dramatically uneven breast development.
There are several procedures that are increasingly performed on teens. For example, liposuction in teenagers is discouraged, but some patients have specific medical conditions that make it appropriate. Obviously, it shouldn’t be done until nonsurgical approaches have been tried.
You should never do surgery — at any age or in any patient — unless the benefits outweigh the risks and the improvement that’s possible is greater than the costs and risks of surgery.
Medscape: This sounds like general guidelines. Are they enforced by any of the Colleges or other agencies?
Dr. McGuire: There are guidelines on the ASPS Website. However, there are no legal restrictions on performing cosmetic surgery on teens. If a plastic surgeon is doing breast implants on 14-year-olds, this should come to the attention of the national society and be subject to investigation, and potentially be considered unethical conduct.
Medscape: Should there be legal limits?
Dr. McGuire: There’s no legal prohibition, and that’s partly because there are often special circumstances. You don’t want a blanket statement. There are cases in which procedures are medically appropriate; you don’t want to be too restrictive.
Medscape: Australia recently passed legislation restricting cosmetic procedures in kids and teens. What do you think of that?
Dr. McGuire: It’s appropriate as long as it’s appropriately worded and unusual circumstances and exceptions are accounted for. That’s tough to do in legislation. Generally, it’s best handled within the specialty.
Medscape: Do teens ever have regrets about their cosmetic surgery in later years? Has anybody studied that?
Dr. McGuire: I’m not aware of any studies. There is always a small percentage of patients, at any age, who have some regrets. That’s why doctors need to try to evaluate “How are you going to feel about this in 2 or 3 years?” and not just “What do you want today?”
Medscape: Do you have any general tips or messages for surgeons on this topic of teens and kids?
Dr. McGuire: Approach teen cases with even greater concern than adults. Consider not only the age and the physical condition but the emotional maturity and mental stability of the teen, more so than in older patients. If it’s clearly an appropriate problem in an appropriate patient with appropriate emotional stability, the results can be more dramatic than in an adult, simply because the whole image issue in teens is much greater than it is in adults.
From Medscape Plastic Surgery & Aesthetic Medicine
Sep
7
The Nonsurgical Nose Job
Filed Under Aesthetic Medicine, Beauty, Plastic Surgery | Leave a Comment
Wish your nose could be different? Smoothen out irregularities? Correcting an downturned nose? There are some ways that a doctor can improve the appearance without you having to go under the knife.
Currently, there is a trend towards using injectable fillers to correct nasal features. For contour irregularities, hyaluronic acid fillers like Restylane, Juvederm, Perlane and Radiesse are most frequently used for injectable nose jobs to smoothen out irregularities.
Botox injections can also be given to relax the facial muscle that pulls the tip of your nose downward to create a more upturned appearance.
Injections can also be given around the nose, to soften the lines around the nose, giving an appearance of a younger looking nose.
However, its best to discuss with your doctor whether your nose is suitable for corrections by using injectables, and which injectables to most suitable for use taking into account your skin features and thickness. For example, Radiesse is injected deeper to fix contour irregularities, while the hyaluronic acids are great for fine creases at the bridge. Also, if it’s your first nonsurgical nose job, your doctor will probably recommend a hyaluronic acid filler since it can be dissolved with an injection of hyaluronidase if you don’t like the results. Radiesse lasts longer, but it costs more, so your budget may also help determine which filler is used.
Previous related posts:
Sep
3
Aging Effects On The Nose
Filed Under Aesthetic medicine, Beauty, Plastic Surgery | Leave a Comment
The nose, as with the rest of the face and skin, is also susceptible to the aging process. Commonly, changes to the nose include drooping of the tip of the nose, contour irregularities, lengthening of the nose, a decreased nasolabial angle, narrowing of the nasal valve, and obstructed nasal breathing.
Drooping of the nasal tip is the one most precalent and distinctive features of an aging nose. It is caused by the weakening of the lower cartilage of the nose, and other supporting structures in the nose. Sometimes, the drooping tip may result in a illusion of a hump on the nose, and perceived septum prominence which is not physically present. Some ways a doctor may help correct the drooping is by using strut grafts in the columella, tip grafts, and various stitching techniques to increase tip support, projection, rotation and correction of contour deformities.
Nasal valve obstruction is common in the elderly, and it’s surprisingly under-recognized as a factor which is important in improving the quality of life. The weakening of the nsasal cartilages and the surrounding support mechanisms can cause collapse of the nasal valves resulting in nasal obstruction, worsened at rest or on breathing in. Surgery may be necessary to correct the problem.
As you age, the nasal bones also thin out and become fragile, making you more susceptible to nose fractures and trauma. The overlying skin also thins out, leading to greater visibility of even minor contour and tip irregularities previously concealed by the thicker nasal skin of youth.
Find out what a non surgical nose job can do for you in my next post!
Aug
31
Perfect Facial Proportions: The Nose
Filed Under Aesthetic Medicine, Beauty, Plastic Surgery | Leave a Comment
The nose is in the middle of the face, and many people are conscious of its position and appearance. Many times we hear people commenting on the type or size of noses another individual has. Some different descriptions of noses we hear are those of:
The Roman or Aquiline Nose: This type of nose is convex in shape, like a hook. It is also known as ‘hooknose’ because of its shape. The word aquiline is derived from the Latin word ‘aquilinus’ which means ‘eagle like’.
The Greek or Straight Nose. This type of nose is perfectly straight with no curves or hooked like shape. It is known as Greek nose because it is generally noticed that the Greek people have this kind of nose.
The Nubian Nose: This type of nose has wide nostrils. It is generally a little narrow at the top, thick and broad at the middle and wide at the end. The term ‘Nubian’ comes from the ethnic group ‘Nubians’ who belong to northern Sudan.
The Hawk Nose: The hawk nose is so called because it is very convex, to the extent that it almost looks like a bow. It is very thin and sharp as well. Since it resembles the beak of a Hawk, it is known as the hawk nose.
Snub Nose: This type of nose is quite short in length and is neither sharp, nor hook like nor wide. It is almost as short as a nose possibly can be. Hence, it is known as snub nose
The turn up Nose: This type of nose is also called as the Celestial nose. It is so called because it runs continuously from the eyes towards the tip.
Like all other features of the face, there are guidelines and measurements that allows the nose to be viewed as more aesthetically pleasing. Here are the proportions for the ‘ideal’ nose:
- The ideal nasal length should be equal the distance from the stomion (the middle point of the oral slit when the lips are closed) to the menton (the lowermost point of the chin when seen in profile).
- The ideal nose tip projection should be equal to 0.66 x ideal nasal length.
- The distance from the infraorbital rim (lower bony edge of the eye socket) to the base of the nose is equal to the width of the base of the nose, and is half the length of the middle third of the face (ie, the distance between the brow to the base of the nose)
- The nose is straight by following a line falling from the midglabellar area (point between the brows), the nasal bridge, the nasal tip and the Cupid’s Bow of the lips.
- The width of the alar base (where the flare of the nose joins the cheek) should be equal to one eye width.
- The width of the bony base of the nose should be 80% of the alar width.
- The alar rims should have a slight outward flare in the inferior direction.
- The lines connecting the tip defining points (the most projecting area on each side of the nose tip), the supratip break area (the depression just above the tip), and the columellar lobular angle (angle formed by the junction of the infra-tip lobule with the columella) form 2 equilateral triangles.
- A line outlining the alar rims and the columella (the skin separating the nostrils) resemble a gull in gentle flight
- From the front, the nasofrontal angle (angle of demarcation between forehead and nasal dorsum, best seen in profile) lies at a level between the upper eyelashes and the supratarsal crease.
- In women, the nasal dorsum should lie 2mm behind and parallel to a line from just above the nasofrontal angle to the tip defining points. In men, the dorsum should be slightly higher.
- 50-60% of the tip should lie in front of a vertical line drawn adjacent to the most projecting portion of a normally positioned upper lip.
- The tip projection should be equivalent to the alar base width.
- The tip rotation is determined by the degree of the nasolabial angle, as measured by the angle between the vertical and a line drawn through the most anterior and posterior edges of the nostrils (normally 95-100° in women and 90-95° in men.
- The columellar lobular angle is approximately 45°.
- On the basal view, the outline of the nasal base forms an equilateral triangle, the lobular to nostril ratio is 1:2.
- The upper lip projects 2mm more than the lower lip, and in women, the chin lies slightly posterior to the lower lip, slightly stronger in men.
- The distance from the angle of the jaw to the menton is half the distance from the menton to the natural hairline.
As always, these are just guidelines, but the final appearance and modifications should be worked through with a qualified plastic surgeon.
Eager to find out what aging does to your nose? Check out the upcoming post!
Jul
14
Perfect Facial Proportions: The Eye and Eyelid
Filed Under Aesthetic medicine, Anatomy, Beauty, Plastic Surgery | Leave a Comment
In this section in the ‘Perfect Facial Proportions’ series, I will be discussing the features that make the eye and eyelid attractive. Undeniably, the eyes are a crucial area of the face, and is often one of the first areas to get noticed and even get judged upon. After all, the eyes tell a lot about your feelings and personality, and can also give away your age. Eye surgery is one of the top cosmetic procedures performed.
Ideal measurements and proportions of a perfect looking beautiful eye:
- symmetrical almond shaped eye
- the highest point of the upper eyelid is positioned at the medial limbus (the inner edge of the colored part of the eye), while the lowest point of the lower eyelid is at the lateral limbus (the outer edge of the colored part of the eye).
- The edges of the eye should be sharp, especially the outer corner. The outer corner should be 2-4mm higher than the inner corner of the eye.
- The size of the eye should be 25-30mm when measured horizontally, and about 10mm measured vertically.
- The upper eyelid crease is well defined, and lies 8-12mm from the lid margin (eyelash line) in a Caucasian patient. A lower lid crease, and excessive eyelid folds gives a tired appearance to the eye.
- The upper eyelid margin should cover the top 1-2mm of the iris, and the lower lid margin should lie at or 1mm below the lower edge of the iris.
To achieve a youthful looking eye area, several characteristic traits are necessary:
- a well shaped and positioned eyebrow (as previously discussed)
- a well defined eyelid crease
- the absence of excessive droopy eyelid skin or fatty skin, which causes the eyelid to close around the eye, making the eye appear smaller
- absence of wrinkles and other lines around the eyes
Next Installment: Perfect Facial Proportions-The Nose
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