February 28, 2010

Should I get laser resurfacing?

As we often say, the key to receiving excellent results from cosmetic treatments is making sure that the treatment is customized to your needs and powerful without being over aggressive.  For a procedure to be beneficial, flexibility is essential.  If your doctor cannot tailor the procedure to your needs, it is likely to be either relatively ineffective or cause problems.

Forms of laser resurfacing are appealing to many doctors because they are easy to learn the public’s infatuation with lasers make the services easy to market.  In fact, surgeons can be trained in a two-day course on how to use a laser while it can take two years of intense fellowship to understand the art and versatility of the chemical peel.  The chemical peel is complex and adaptable, but after spending $150,000 on a laser,  a doctor will want to recoup these costs and will have little incentive to offer laser resurfacing alternatives.

Superficial Improvements

There are several facial laser treatment problems, one being that you may pay a lot for an expensive technology that doesn’t make a meaningful difference in your appearance.

The cost of this expensive technology is passed onto you, the client, which is fair, but it can mean that results are disappointing when you consider the price you pay.  For example, Fraxel laser treatments are considered very mild.  They do freshen up your complexion but will you be disappointed with the results if you don’t make enough progress in tightening the skin or providing dramatic improvements?

Laser peels are also usually performed with an erbium laser, and they are considered so mild that the treatment is rendered superficial, producing results comparable to microdermabrasion.  While this provides minimal improvement, the machine is still very costly, and you will have to pay a lot for this type of service.  Fractional C02 laser resurfacing achieves results that are similar to light chemical peels and certainly much more effective than microdermabrasion.  Again how you feel about the improvement has to be balanced against what you have had to pay for the service.

Side Effects from Overagressive Treatments

Deep CO2 laser resurfacing has fallen out of fashion because of the negative experience many have had healing from these treatments.  Before considering such a treatment it’s important to understand the real risk that your skin will suffer from permanent depigmentation, and that the scarring caused by such treatments will likely affect the texture of your face.  This is because the treatment depth needed to improve deep facial lines makes post laser resurfacing scars, particularly skin texture changes, relatively common.  In fact these types of skin texture changes and skin depigmentation are so common that many surgeons think that this is the expected outcome of the service!  This creates a permanent unnatural color change in the skin.  Will this type of change be worth living with?  For many younger individuals, the answer is no.  However, some older women who rely on foundation to improve the tone of the complexion may find that it is not a problem to continue the use of foundation to add color to the face after deep CO2 laser and appreciate the improvement in facial lines.

Facial laser procedures began as a promising technology that some even believed would replace the time tested and reliable chemical peel, but now we are seeing that the technology has ultimately been a disappointment.  In order to achieve line improvement with laser resurfacing, the unwanted treatment side effects are unavoidable.  With other kinds of laser, we see that the laser peel is so mild that the improvements, for many, are not worth the financial costs.  These problems can be traced back to the inflexibility of laser treatments making them suitable for treating a narrow range of complexion issues.

Laser Resurfacing vs. Chemical Peel

A chemical peel has the ability to rejuvenate your skin and restore your face’s youthful appearance through a carefully designed treatment plan.  Chemical peels are truly an art form with many options that make your treatment customizable and safe, and they’ve been the preferred facial resurfacing method for much longer than laser treatments have been available.  There is still a very small chance of change in pigmentation, but when we look at the chemical peel vs. laser treatment we see that the chemical peel is less likely to produce unwanted skin color and texture problems.  However, due to the experience and level of skill needed to perform this procedure, only a very limited number of surgeons are truly qualified to perform these procedures

You need an expert in chemical peels.

Dr. Steinsapir is a considered a master chemical peeler who is able to custom-tailor a peel to your unique needs.  He specializes in achieving natural results with little down time by using minimally invasive procedures like the chemical peel.  It is his philosophy to approach your needs on an individual basis and then carefully plan your treatment.  Because Dr. Steinsapir never standardizes cosmetic treatments into a cookie-cutter, assembly-line approach, he can help you achieve benefits that work just right for you.  Please contact us today to learn more about how a chemical peel or another option can achieve your personal goals.

February 21, 2010

I am thinking about getting neck liposuction.

Neck liposuction can be a great sculpting tool for those who hold excess fat in their necks that doesn’t go away with dieting and exercise.  Liposuction is a powerful sculpting procedure for those who seek firming of the lower face and neck.  Liposuction in these areas is an easy, powerful alternative to facelift, and it compliments the facelift for those who opt for both.  While excess weight does show up in the face, if you have already dieted and still cannot resolve this problem area then you may be a great candidate for neck liposuction.

Neck Liposuction Before and After Photo

Neck Liposuction Before and After Photo

In general, liposuction targets stubborn problem areas that persist in spite of a healthy lifestyle.  Any liposuction, including face and neck liposuction, will not change your weight.  Rather, the contour of your body will improve through sculpting.  Because we so often show even small fluctuations of weight in our faces, your friends will assume that you’ve lost weight after your neck and lower face liposuction procedure.  The benefits are double: neck liposuction will improve the aesthetic appeal of your face, and the improved contour will suggest a slimmer new you even though your weight hasn’t changed.  More important you will look younger because fullness of the lower half of the face is associated with aging.  Improving the contour can easily make one look 10 years younger.

Who needs neck liposuction?

The best candidates for lower face and neck liposuction are those who:

1.    Are looking for a younger, fresher look without undergoing a face lift..
2.    Have stable weight with sufficient fullness in the lower face and neck.
3.    Have minimal or no neck cords.

The lower face and neck responds very well to liposuction.  This includes the  area under the chin. Because our brains are programmed for facial recognition, even small changes in and around the face make a large difference in how people perceive you.  When you remove excess fat from the lower face and neck, your friends will probably think immediately think that you have lost weight.  In addition, you will look younger because this procedure creates better visual separation between the lower face and neck that is associated with youth.

Liposuction skin tightening
is a common benefit in this area as well. Skin with proper tension is a feature of a youthful face.  The liposuction procedure appears to stimulate contraction of skin effectively preventing skin sag after the liposuction procedure.

Is neck liposuction safe?


Neck liposuction complications
are unusual, especially when performed under local anesthesia.   Yes this procedure can be performed in an office procedure room with you awake and alert.  That is how comfortable the procedure is.  There is often no bruising associated with the procedure.  Many find that they can have the procedure on a Thursday and return to work on Monday and no one is aware that they had surgery.

The safest kind of liposuction, called tumescent liposuction, is performed under local anesthesia using very small cannulas to remove the fat.  In a review of 66,570 cases of tumescent liposuction, there were no serious health issues.  These impressive results indicate tumescent liposuction safety.  This procedure takes your cosmetic surgeon more time to perform, as it requires meticulous attention and the gentlest hand, resulting in detail-oriented contour improvement.  Recovery is swift;  recovery from, tumescent liposuction recovery time is only a few days.  It is worth repeating that you can receive the procedure Thursday morning and return to work Monday without anyone noticing a change.  At first neck liposuction swelling will replace the removed fat.  As this swelling decreases, your improved contour will become evident and people will assume you have lost weight.  The gradual yet definite change you see here makes tumescent neck liposuction a fantastic option for those who don’t want anyone to guess that they’ve had work done.

Choosing a Liposuction Doctor

The face is a dynamic and sensitive part of the body that requires the hand of an artistic doctor as much as a skilled one.  Research doctors and find one who makes sense to you and takes the time to determine the best individualized treatment program for your needs.  Be suspicious of doctors who prefer to perform liposuction under general anesthesia.  Unless you have unusual circumstances that require general anesthesia is better in your unique case, local anesthesia is the way to go.  Don’t just have general anesthesia because your surgeon likes to flirt with the nursing staff during surgery and he or she doesn’t want you to be aware of this banter. Avoiding general anesthesia means far fewer drugs for your system to deal with.  It just make sense that this is much safer than all the drugs and invasive procedures needed for general anesthesia and medical studies support this conclusion.

Dr. Steinsapir
only performs tumescent liposuction because of its superior results and fast, comfortable recovery time.  If you have questions about how lower face and neck liposuction can help you, or whether you are a good candidate please call us today for a no-risk consultation.

February 17, 2010

Will getting BOTOX and Restylane make me look worse when they wear off?

Let’s clear up this misconception right away: as the effects of your treatment begin to wear off after several months, your face will slowly regain the looks it had immediately before your treatment, but there is no evidence that Restylane and BOTOX treatments will make you look worse.  The only change is that you looked better for 4 months in the case of BOTOX and over a year in the case of Restylane.  They have very few side effects, which are generally mild anyway.  If you aren’t happy with your results then simply don’t return for re-treatment and you will return to exactly what you used to look like.

before and after Restylane and BOTOX photo

before and after Restylane and BOTOX photo

Are the scary stories I’ve heard true?

A lot of people are apprehensive when it comes to receiving cosmetic treatments.  With all the media scares, rumors about celebrity BOTOX disasters, and misinformation abound, it can be a challenge to sort the truth from the hype.  It can be even more of a challenge to separate an extremely rare risk from typical outcomes.  For example, an unusual story of something that happened one time may technically be an accurate story, but it ventures into dishonesty as soon as it’s misrepresented as a typical event.  In the cases of BOTOX and Restylane, it’s true that in rare cases there can be side effects that are usually mild and not long-lasting, but if you are thinking of a particular public face that just hasn’t been the same in years, then you probably aren’t looking at before and after photos of Restylane and BOTOX, as these treatments wear off over time.  It is treatments like silicone oil, excessive surgery, and simply the ravages of excessive lifestyles that create long term damage to the faces of our celebrities.

People love to talk about dramatic, dangerous situations.  But the truth is, BOTOX and Restylane have an incredibly safe history with results that aren’t permanent.

How will BOTOX and Restylane change my face?

Treatments like BOTOX and Restylane are popular because they are noninvasive treatments that together can smooth wrinkles, relax tense muscles, and fill in hollow areas.  They are remarkably safe and, since they aren’t permanent, create a win-win situation.  If you are happy with your BOTOX or Restylane treatment, touch-up the treatment when need.  If you are not thrilled, let it wear off and move on to something else.  Sometimes we hear patients ask questions like, does BOTOX make wrinkles worse?  Sometimes they express concern about what happens after Restylane injections wear off.

We cannot emphasize enough that BOTOX and Restylane will not permanently alter your looks.  BOTOX is a naturally-occuring muscle relaxant compound, and Restylane is made from a biodegradable sugar-gel that occurs naturally in the body.  Both of these are eventually broken down and expelled from your body completely.  You’ll notice as this happens that your wrinkles will slowly return.  They may stand out to you after months of looking much better, in some cases, fantastic, but if you look at photos of yourself from before treatment, you will see that your problems have not been made worse by treatment.  You are simply getting your old face back.  Will this make you feel like you need more treatment-absolutely because these treatments are truly effective.

In the short run, BOTOX and Restylane will give you a youthful appearance and resolve many problems.  In the long run, BOTOX and Restylane will not affect your looks after you allow their effects to wear off.  A difference between BOTOX and Restylane is that BOTOX treatments are generally needed twice a year, while Restylane is needed once a year.  Most patients opt for retreatment when they see their old problems beginning to return.  This will maintain the natural-looking results gained from treatment.

Can BOTOX and Restylane prevent problems?

We are often asked questions like, can BOTOX prevent wrinkles?  We know that BOTOX does not aggravate wrinkles or make them worse in the long run.  We also know that the face is subject to gravity and general usage as we age, and that wrinkles can be caused by tense muscles.  When these overactive muscles relax, as they do in response to BOTOX, the skin is no longer constantly being creased.  This is similar to a folded piece of cloth; if you take a wrinkle-free piece of cloth and fold it over, then bring it back, you’ll see that it doesn’t “remember” the fold and is not wrinkled.  However, if you fold that same piece of cloth and place it under a book overnight, it will have a set crease when you come back to it.  When BOTOX and Restylane dissipate wrinkles, they are keeping the skin taut so it doesn’t “remember” those problems that BOTOX and Restylane prevent.

The Bottom Line

When Restylane and BOTOX wear off, you will look exactly as you did before treatment, although 6 to 16 months older.  You will not look worse as a result of Restylane or BOTOX wearing off.  If anything, you may have delayed the aging process.  It is understandable why people maintain treatment effects by refreshing their service when the feel it is necessary.

An Individual Treatment Program

Now that you’ve done some research on BOTOX and Restylane treatments, you’re ready to take the next step: research a doctor who can answer the rest of your questions and decide if treatment is right for you.  Dr. Steinsapir specializes in cosmetic facial treatments like Restylane and BOTOX in Beverly Hills and Los Angeles.  Dr. Steinsapir is a leader in facial cosmetic treatments and has innovated advanced treatments like Deepfill Restylane and Microdroplet BOTOX.  Call us today to find out how Dr. Steinsapir can individualize your treatment plan.

February 16, 2010

Which Type of Facelift Should I Get?

There are a lot of facelift methods you’ve probably heard about and it can be confusing to figure out the best one for your particular needs.  Our advice?  Don’t try to figure out which type of facelift you need because you’re asking the wrong question.  A great facelift is not characterized by type, but by customization.  The best way to get disappointing results is by looking for a cookie-cutter procedure.  A skilled surgeon can produce amazing results with almost any method if he or she customizes the procedure to your individual circumstances.

facelift before and after photo

facelift before and after photo

The right facelift surgery for you is not a matter of reading about incision methods, dissection planes, or vectors of lift, but about finding a reputable surgeon whose results (unretouched before and after photos) you like. You need to be comfortable in your surgeon’s ability both through your research and through an individual consultation.  If your potential surgeon says that every facelift procedure is the same or the focus is on how fast the surgery can be performed, it’s time to worry.  The best type of facelift is one tailored to meet your needs.  Whether it be the deep plane lift, the superficial musculoaponeurotic system (SMAS) facelift, an endoscopic facelift, S-lift, or a MACS lift, the short scar facelift, or another method, the procedure must be customized to your unique features and goals to obtain natural, satisfying results.

How does the Deep Plane Facelift compare to other methods?

As stated above, most any type of facelift can procure excellent results if customized by an experienced facial cosmetic surgeon.  The deep plane facelift can be as effective as other methods, but the problem is that this is a riskier procedure and the benefits usually aren’t worth the risk when there are other options available.  With the deep plane facelift, there is an increased chance of injury to a facial nerve that can even happen in the best of hands.  The chance of these facelift complications are small but if it happens to you, it was 100%.  If this happens to you, some of your facial muscles will cease to work properly.  Since properly functioning facial muscles are essential to your appearance, your results will not be good.  Since there is no clear advantage to the deep lane facelift, why take the risk, even if it’s small?  If you are set on receiving this method, you will probably find someone who will perform it for you if you knock on enough doors and have enough money, but may end up regretting your inflexibility.

Can I use a home remedy?

There are a lot of proclamations about so-called miracle cures, like a non-surgical facelifts at home.  A useful rule to follow is this: if it sounds too good to be true, it probably is.  If someone tells you they can give you a facelift in a bottle, be skeptical.  The truth is that moisturizers, so-called facelift creams, and other concoctions are generally a waste of money.  If you think about the hyped claims for these products, you’ll realize they don’t make logical sense.  There is certainly nothing stopping you from testing out these promises, but don’t expect much from them.

If what you really want is a facelift alternative, seek a personal consultation with an esteemed and qualified facial cosmetic surgeon.  A facelift is usually not indicated without the loose “turkey” neck skin, and in many cases a treatment like BOTOX or safe neck liposuction is a good option.

The Bottom Line

Of all cosmetic facial procedures, a facelift is the most powerful.  When it comes to something so important and complex, to obtain the best results it’s critical that you allow your physician the flexibility needed to customize your results.

Dr. Steinsapir is a cosmetic surgeon in Los Angeles who strives for the most natural, youthful results through minimally invasive procedures with the shortest possible recovery times.  He has been a leader in the move toward small-incision facelifts since 1990.  He is a Clinical Associate Professor of Oculofacial Surgery at UCLA.  Your surgery will be in the safety of the Surgery Center at the UCLA Medical Center.    Dr. Steinsapir is sought out by individuals both in California and across the nation and world for his expertise in designing individual facelifts and other facial cosmetic procedures.  Rather than directing you to a technician, nurse, or assistant, Dr. Steinsapir is personally available to answer your facelift questions, discuss options suitable to your aesthetic needs, and work with you to customize your facelift if your assessment indicates that one is needed. Contact us today for an individual assessment.

February 11, 2010

Common Questions about Under Eye Restylane

When do I need under eye Restylane?

You are a good candidate for under eye Restylane treatment if you have dark circles under your eyes or hollow facial features that make your eyes look tired and aged.  Restylane can restore volume under the eyes to give you a naturally youthful, soft, and alert appearance.

undereye Restylane before and after photo

undereye Restylane before and after photo

How long does under eye Restylane last?

Restylane treatments last for an impressive length of time.  You can expect benefits for a year or more.  Your doctor will discuss follow-up treatments with you after assessing your situation and goals.  The long-lasting effect of Restylane are a great convenience.

How is Restylane better than a permanent or fat filler?

Different fillers work great for different needs.  Restylane is usually the best choice for the under eye area because the skin in this region is very thin.  With so little room to hide a permanent filler, the margin for error here is low.  This is why a flexible, easily adjustable filler is essential.  Restylane is exceptionally appropriate for treating dark circles under the eyes because of its smoothness and flexibility.  If you experience any irregularity in the smoothness of your skin after treatment, Restylane is easily adjusted without surgery.

How much Restylane do I need under my eyes?

The average under eye circle each requires about 1 milliliter of Restylane to resolve the problem.  This quantity of course varies up and down depending on the severity and each recipient’s unique facial anatomy.

How much does Restylane cost?

Quality cosmetic treatments aren’t cheap, and you are unlikely to get good results if you seek out the cheapest procedure and provider.   If you are concerned about financing your individualized treatment program, talk to your doctor at your consultation.  Dr. Steinsapir works with patients to find them the best treatment they can afford, and after a no-risk assessment we can give you a precise quote.  Rather than seek partial treatment because of a tight budget, it’s best to completely resolve the issue.

How long is recovery time?

Healing from an under eye restylane treatment is swift, and you can usually resume normal activities within hours of treatment.  You will likely experience mild swelling for thirty to forty hours of treatment.  Both men and women can hide this slight redness immediately or within a few hours with some cover-up makeup.  Brusiing discussed below can also occur which may increase the recovery time.

Are there side effects?

Some degree of bruising occurs in about 20% of Restylane dark circles treatments.  This can range from a barely detectable micro-bruise to, in a few rare cases, a black eye.  Since a black eye fully resolves itself in just two or three weeks, this isn’t considered a serious side effect or barrier to treatment.  Just be sure not to get your treatment the day before your wedding or other event where you may be photographed, and you have little to worry about.

Some people with exceptionally sensitive skin may experience mild tenderness, discomfort, or itching, which resolves itself within a couple days.  Restylane side effects are uncommon and almost always very mild in nature.  The nature of associated side effects is that they will go away quickly on their own.

How can I prevent bruising?

Certain medicines like aspirin and many herbs thin the blood.  Normally this effect is so small that it doesn’t matter, but when you’re receiving Restylane treatment you should avoid these things for about ten days before treatment.  Your doctor can give you a list of drugs, herbs, wines, and so on to avoid.  If you are on a prescription medication, be sure to bring this up with both your cosmetic physician and the doctor who prescribed the medication.  If it’s important for you to take something everyday, you are probably still an excellent candidate for treatment; just realize that your risk for bruising is a little elevated, and that the bruising will go away.

How soon will I see results?

As soon as you leave the office, you will see that the hollows under your eyes have dramatically improved.

Who should give Restylane injections?

Restylane injections require the hand of a skilled specialist who is both qualified and experienced in providing Restylane treatments.  Those who are qualified to provide Restylane treatments include general plastic surgeons (aka board certified general plastic surgeons), fellowship trained eye plastic surgeons, facial plastic surgeons, and dermatologists.  This doesn’t mean that everyone who can legally treat you is a good choice for what you need.  Restylane is considered a safe, minimally invasive treatment that is very easy on the recipient, but applying Restylane is also the most difficult of under eye treatments, and it demands a highly experienced professional with both skill and an artistic eye.  You need to find a qualified specialist who is comfortable and expert at this type of treatment.

How can I individualize my treatment program?

Our office believes in providing the best boutique care and natural results.  Dr. Steinsapir performs all services himself without relying on assistants.  We believe in approaching each patient as an individual, paying special attention to your health history, your goals and concerns, taking time to listen to your individual concerns with interest and care, and creating an individual plan that will work for you.  Call us today for a no-risk assessment.

February 2, 2010

Is a Thread Lift a Good Alternative to the Facelift?

The thread lift or suture lift is often advertised as a cheap alternative to the facelift, and like so many things that sound too good to be true, it probably is.  The thread lift is a procedure in which a barbed suture is threaded through the face.  This is supposed to lift the face with minimal surgery.  It costs less than a facelift, yes, and sometimes recovery time is shorter, but this procedure doesn’t last and can have associated complications.  Many cosmetic surgeons do not perform thread lifts because they feel that they are ineffective.

The problem with relying on a barbed thread to improve facial features is that the threads can break or move, and you may be able to feel them.  You may not see any improvement, and if you do, it will likely last only a few weeks or months.  The thread lift is a superficial treatment that may temporarily improve problems like cheek ptosis, but it’s unlikely to give you lasting change.

Who Gets Thread Lifts?

Those targeted in ads for thread lifts are often those who worry about the cost of treatment and are looking for the best deal.  Unfortunately, when it comes to health care and cosmetic treatments, “the best deal” can sometimes mean the worst service.  The truth is that the best surgeons are expensive, and effective treatments cost time and money.  When you consider how costly medical school is and all the investment a doctor must put into his or her career on top of the high demand for the most skilled and experienced providers, it’s easy to see the great value in a procedure done right.  While a thread lift may cost less right now, if you think about how long it lasts and what you’ll have to pay for future corrective procedures, the thread lift is actually far more costly than it seems.

Another demographic commonly targeted for the thread lift are those who are young or appear young enough to not require dramatic change.  Thread lift providers may focus on people in their 30s who have faces that are just beginning to show signs of age.  The reason why the emphasis is on those seeking subtle improvements is because the thread lift is not considered a powerful procedure.  It simply isn’t capable of giving the results required by someone with more severe signs of aging.  People in this age group do much better with appropriate non-invasive treatments like Restylane and BOTOX.

Removing the Sutures Later

Not everyone has to have the sutures removed, but many people who are dissatisfied with their thread lift opt to have them taken out later on, especially if they are experiencing facial discomfort or seeking further treatment.  Removing the sutures can be a lengthy process, and one that should be done if you wish to receive a facelift later.  Having the sutures removed will add to your bill and increase your risks of complications.

Facelift: The Smart Solution

If you are concerned about your aging, sagging face, do yourself a favor and seek treatment that will last.  If your concerns are minimal, consider seeking a consultation to find out if nonsurgical treatments are more suitable.  For those who need surgery, a facelift is almost always a wiser choice than a thread lift, and for those with minor problems, there are minimally invasive cosmetic treatments available that you may not have considered.

The facelift is a dynamic procedure that gives real results and can be completely custom-designed for your needs.  There is a lot of flexibility with designing the best treatment program for you without resorting to thread lifts.

Complications

As with any treatment, there is a small risk of complications like numbness or suture migration.  What should most concern you is the significant risk that you will receive no improvement from this procedure.  If you do experience improvement, you still run the large risk of having this improvement last only a few weeks before the suture strips in the tissue.  For these reasons we recommend seeking alternative forms of treatment.

Seeking Advice

Find a doctor who specializes in multiple procedures that improve facial structure and aesthetics.  This way you will receive balanced advice.  A doctor with extensive experience in facial cosmetic procedures will best understand your options, rather than rely on thread lifts as a default.  As an incredibly complex and potentially beautiful part of the human body, the face must be treated on an individual basis with regard for its sensitivity and respect for its proven treatments.

Dr. Steinsapir is widely experienced in specialized facial treatments, including the facelift, BOTOX, Restylane, facial liposuction, reconstructive surgery, and more.  With resources available in his Beverly Hills practice and UCLA, Dr. Steinsapir uses proven facial treatments and insight gleaned from years of experience as a specialized physician.  Dr. Steinsapir always treats patients himself without relying on nurses, technicians, associates, or ghost surgeons.  Call us today to learn how to improve your facial structure through proven methods.