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November 2, 2010

I’ve heard that the enzyme that erases Restylane wrecks the skin. Is that true?

Filed under: Beverly Hills Restylane,eyelid filler,facial fillers,hyaluronic acid fillers,Juvederm,Perlane,Restylane,Under Eye Restylane — Tags: , , , , — admin @ 8:42 pm

One reason why fillers like Restylane and Juvederm have been so successful is because these treatments can be adjusted using an injectable enzyme called hyaluronidase, an egg-based enzyme that works as a sort of “erasure” to modify lumps and bumps that may occur as a result of facial filler treatment.   Individuals with a history of allergies to egg based vaccines should inform their physician prior to treatment with hyaluronic acid fillers.

Some people are nervous about seeking treatment because they’re not sure if they will like their new look and they want to have the option of reversing any undesirable results, or they simply wish to be able to change their mind later.  Still others may be concerned that if they are dissatisfied with a filler treatment that they’ve already had, will they make things even worse by seeking a correction?  These are understandable fears, but fortunately they are largely unfounded.  There is no reason to believe that hyaluronidase will ruin your skin or make matters worse.  Routinely, hyaluronidase is used to adjust hyaluronic acid filler treatments.  While every medical procedure comes with a risk, and while it is possible that you are one of the rare individuals who could experience an allergic reaction, this is not likely.  A reputable cosmetic surgeon can safely make adjustments, and in the unlikely event of a complication, your physician will know what to do.

How did the rumors about hyaluronidase get started?

At first when Juvederm and Restylane were being introduced as valuable cosmetic products, some dermatologists were concerned that some people could potentially have an allergic reaction to the enzyme.  However, as time went on hyaluronidase benefited numerous treatment recipients who sought adjustment, it became clear that this enzyme is a safe way to make sure that treatments with hyaluronic acid fillers like Restylane, Perlane, and Juvederm achieve the best results.

Eye plastic surgeons are some of the professionals who use hyaluronidase the most, and they have found the enzyme to be reliable.  Dr. Steinsapir has used this product for over 20 years, and hasn’t seen an allergic reaction yet.  While there is always a chance of a negative response in the body, oculofacial surgeons have integrated the enzyme with hyaluronic acid filler product treatment as if it’s an eraser to modify a treatment after the fact.  Since adjusting filler treatment with hyaluronidase is truly an art form, some less experienced providers are not comfortable with this practice.  It is important to seek treatment from someone whose forte is facial fillers and cosmetic eye treatments.   These days the core specialists in hyaluronic acid are quite comfortable using the enzyme to adjust overfill.

How will I look after my hyaluronidase adjustment?

This depends on your goals and the extent of the adjustment.  In most cases, you’ll want your physician to adjust a highlight, or an area of fullness that detracts from the overall treatment effect to obtain an overall treatment effect.  He or she can do this comfortably and with a high degree of accuracy.  The enzyme can be used essentially until the original filler disappears from the face, so it’s also possible to have the filler broken down completely.  If for any reason you choose to go this route, you can expect to look the same as you always have after giving your body some time to completely heal and for any accompanying swelling to subside.  Generally Dr. Steinsapir does not advocate flooding an area to “erase all the product.”  Instead it is best to sculpt the product and make the most of what has already been placed.  Adjusting the work of other injectors is a reason than many new clients seek out Dr. Steinsapir.

You should never accept filler treatment that is touted as permanent or semipermanent.  This will make it difficult to make adjustments, and it doesn’t account for the changes in the face over time.  Later in life, exactly where and how you need help will change.

If you’ve already been treated with Restylane, Perlane, or Juvederm and feel that your treatment can benefit from some adjustment, don’t simply wait for the product to wear off.  You may have to live with you unsatisfactory results for a full year or more, and after that you will likely be nervous about seeking further help.  Have your treatment adjusted right away so you can see the real and safe benefits of cosmetic facial fillers and realize the benefits of your treatment.

Seeking the Best Filler Treatment Available

If you have already received hyaluronic acid filler injections and seek modification, in most cases you can talk with your treatment provider about revisions.  If you aren’t confident in your doctor’s abilities or do not have a positive relationship with him or her, seek a second opinion from an acclaimed expert in facial fillers with natural results.

Dr. Steinsapir is a world-renowned fillers expert and has served as a physician consultant to Medicis, Inc., the distributor of Restylane and Perlane.  He also invented Deepfill method for placing Restylane, a proven method for correcting dark circles under the eyes.  Those who seek treatment with Dr. Steinsapir are almost always very happy with their initial treatment, but in the event that your filler needs adjustment, Dr. Steinsapir can also provide the service of safely and comfortably adjusting your treatment with confidence.  Contact us today to learn more about how Dr. Steinsapir can assure that your treatment results are natural and customizable to your goals.

September 21, 2010

Are the Current Fillers Better Than Collagen?

Filed under: collagen,eyelid filler,facial fillers,lip augmentation,lip fillers,lip injections — Tags: , , , , — admin @ 10:03 am

Collagen was the original facial filler and, for much time, it was the only viable filler available.  It was offered as Zyderm I, Zyderm II, and Zyplast.  The Zyderm benefits did not last very long, and the Zyplast effects only lasted a couple months.  While these proved to be great products for treating problems in facial deficiencies like the edge of the lips, their relatively short life span made them a solution essentially only viable for the wealthy who could afford frequent treatment.  Today collagen products have largely been replaced by the hyaluronic acid fillers called Restylane, Perlane, and Juvederm.  Since both of these types of facial fillers can successfully improve the facial contours, let’s examine the hyaluronic fillers further before drawing any conclusions.

What Is the Difference between Collagen and Hyaluronic Acid Fillers?

Collagen is a naturally occurring protein that works as the primary building block to hold together our tissues.  As the original injectable facial filler, it’s typically derived from bovine, porcine, or human materials.  In the example of bovine-derived collagen, the collagen is extracted from cows raised in a controlled environment free of disease and closely monitored.  Allergan, Inc. creates Zyderm and Zyplast from a highly purified collagen taken from a closed bovine herd, ensuring that their product is safe and high quality.  You do need to obtain an allergy test before receiving bovine collagen filler because there is a three to eight percent chance that of an allergic reaction.  The other collagen fillers like Cosmoplast and Cosmoderm come from cultured human cells, and you do not need an allergy test before treatment.   These later products have replaced the original bovine Zyderm and Zyplast products.  Finally, Evolence is the newer collagen product that is derived from porcine and has a longer life than other forms of collagen.

While the amount of time that collagen lasts depends on the individual, it generally does not last nearly as long as the hyaluronic acids.  Both collagen and hyaluronic acid injections are effective in treating concerns like fine lines, deep wrinkles, crow’s feet, brow wrinkles, and frown lines.  Hyaluronic acid is found naturally in the human body as well, and it is an important part of the processes that regulate cell renewal and growth.  When we put hyaluronic acid into the body, it is non-immunogenic, meaning that it is not seen as a foreign substance by the body.  Therefore, while it is possible you could be allergic to a hyaluronic acid filler, the chances are minimal and unlike collagen products usually no allergy tests are recommended before treatment.  Furthermore, hyaluronic acid fillers last longer, and they are easily and comfortably adjusted with the enzyme hyaluronidase.

Is Collagen or Hyaluronic Acid Better?

The filler that’s right for you will depend on many individual circumstances.  Your doctor will consider your goals, the site(s) of treatment, your health and medical background, and many other factors when helping you to choose the best treatment plan for you.  For example, if you are getting a lip filler, both collagen and hyaluronic acid fillers can work well, with the results of hyaluronic fillers like Restylane lasting longer and being more easily adjustable.  If you are seeking a filler for under eye hollows, then under eye Restylane is usually the best choice.  If you have nasolabial folds, Juvederm may be a suitable filler.  The top choice will really depend on your consultation with a qualified cosmetic surgeon who specializes in cosmetic facial fillers, although in most cases the modern hyaluronic acids will be recommended.

Seek Advice from a Doctor Who Cares

Dr. Steinsapir specializes in minimally invasive facial cosmetic procedures and is a physician consultant to Medicis, Inc., who distributes Restylane and Perlane.  He has developed a highly effective undereye treatment method called DeepFill Restylane, which is widely used by other cosmetic surgeons and world-acclaimed.  As a board certified ophthalmologist, fellowship trained in both cosmetic and eye plastic surgery, Dr. Steinsapir strives for natural results that achieve complete facial balance and fast healing times.  To speak with a doctor who listens, and to learn more about how a facial filler might help you, contact us today to set up your risk-free consultation with Dr. Steinsapir.

September 8, 2010

How do fillers improve my dark circles?

Filed under: Beverly Hills Restylane,eyelid filler,Restylane,restylane in los angeles,Under Eye Restylane — Tags: , , , , , — admin @ 12:46 am

Dark circles under they eye are a common problem that can affect people of all ages.  Effective treatment must address the root cause of the problem, which is why putting on makeup or a face cream does not resolve the issue.  If you are dissatisfied with your appearance because of under eye hollows that give you a tired, haggard, or sunken appearance, consider how an under eye filler like Restylane can improve your image.

Under Eye Restylane Before and After Photo

Under Eye Restylane Before and After Photo

What is the root problem of my dark circles?

While a number of factors contribute to the dark circles under the eyes, lack of soft tissue volume is one of the most important factors.  What we observe here is a deficiency of subcutaneous fat including the fat just underneath our skin.  Just as too much fat is not attractive or good for our health, neither is too little fat.  As we age, many people find that they have problems with fat distribution over the body, having too much in some areas and too little in others, such as the area around the eyes.

With under eye circles, the concern is deflation of the malar fat pad, which composes much of the cheek soft tissue.  This can happen because of gravity, stress, age, or even our genetic tendency.  Skin optics also contributes to the darkness we associate with the dark circle.  The lower eyelid skin is very thin and immediately lined by a flat muscle just under the skin called the orbicularis oculi muscle.  This muscle helps close the eye and also contributes to the smile lines.  The muscle is dark red.  Light that passes through the skin strikes this dark muscle where the light is absorbed.  With little light bouncing back into the skin, this skin appears dark.  In comparison the skin of the cheek just adjacent to the thin eyelid skin has a layer of yellow fat immediately under the skin.  Light passing into the skin a this point strikes the yellow fat and instead of being adsorbed, it reflects off of the fat helping the overlying skin look lighter.  Dark concealers generally contain reflective material such as mica to increase skin reflectivity or are opaque to block the absorption of light at the skin surface.  Unfortunately these products do not eliminate the shadowing that occurs here because of the lack of volume.

Dark circle treatment that works is available through the midface lift, a surgery that corrects the shift in fat distribution, and also through under eye Restylane, a facial filler that restores the tissue deficiency under the eye.

How do fillers resolve the key issue?

Fillers can resolve the deficiency by taking the place of the fat volume that is supposed to be there.   This corrects the hollowed area by addressing the lack of volume and improving the way that light interacts with the tissue in this area.  We have found that Restylane filler is the most suitable filler here because it is safe and does not tend to clump or migrate.  Since there is so little fat here and the skin is thin, there isn’t tissue for the filler to “hide” behind, which is why it’s so important to choose the right filler.   It is also why it is so important to choose the right cosmetic surgeon to perform your service.

Restylane for under eye bags can be modified with the injection of hyaluronidase, an enzyme that breaks down hyaluronic acids including Restylane.  This means that if you have a lump or a bump that needs to be adjusted after initial treatment there is a mechanism to permit this adjustment.

How can I find out if filler will help me?

You need a consultation with physician considered one of the top practitioners in correcting dark circles and other cosmetic facial and eye concerns.  Dr. Steinsapir is one of the best cosmetic surgeons in Los Angeles, and he specializes in minimally invasive techniques to enhance your features through natural results.  His practice is one of the few in the world that makes eye hollow treatment a major focus of practice.  To learn more about Dr. Steinsapir’s prestigious educational and experienced background, as well as how safe treatment with under eye Restylane can help you achieve your desired look, contact us today for a no-risk consultation.

August 2, 2010

What are the best lasers to improve my dark circles?

Filed under: eyelid filler,facelift alternative,facial fillers,midface lift,Restylane,restylane in los angeles,restylane los angeles,Under Eye Restylane — Tags: , , , , , , — admin @ 8:12 pm

People love to talk about lasers and technology, and while lasers are very valuable in many medical procedures, they have a limited place in cosmetic procedures.  Lasers have been touted as a great way to improve skin texture, scars, and even problems like dark circles under the eyes which are actually caused by the skin optics of the lower eyelid.  In actuality, lasers once seemed like a promising technology that failed to deliver on so many promises when it comes to cosmetic treatment.

Under Eye Restylane Before and After Photo

Under Eye Restylane Before and After Photo

There are many potentially disfiguring side effects with laser skin treatments.  For example, CO2 laser resurfacing can cause textural abnormalities and injure the skin’s melanocytes, which causes unsightly hypopigmentation.  Still other methods like fractional laser treatments have such a mild effect that you may or may not even notice a difference.  Furthermore, since laser equipment is so expensive, you end up bearing the high cost as the consumer even when a less expensive treatment may be more effective.  We do not mean to completely devalue lasers; it is of course reasonable and fair that the treatment recipient bears the cost of the medical equipment and procedure, and there are in fact some delicate and truly impressive surgeries that are best done with a laser.  However, when it comes to cosmetic procedures and facial skin treatments, lasers are often not the best choice.

What is the best treatment to improve my dark circles?

Let’s rephrase the original question and consider how to find a more appropriate treatment solution.  Some better questions to ask are, what is causing my dark circles, and what is the best cosmetic treatment to improve them?  This way you allow your physician to diagnose you and help you develop the best treatment plan for your needs, rather than assuming that you already know what will work.  Just as it is a common misconception that lasers are the best method for treating facial skin problems, it is also a misconception that the dark circles or under eye hollows are a problem with skin pigmentation.

In most cases, the dark circles under the eyes that we observe are actually caused by a tissue deficiency.  There is too little subcutaneous (meaning “under the skin”) fat in the under-eye region, which is frequently caused by a descent of the malar fat pad, or soft cheek tissue, over time.  This deficiency creates an optical problem because light hitting the skin is absorbed by the dark red muscle beneath it, rather than a youthful layer of fat.  The tear trough skin here may be too thin also, compounding the problem, but this is not a skin problem you’ll want to “correct” with lasers.  The skin here is very delicate and fragile, and artificially changing its texture through lasers and scarring will not make for a good look.  The key is to address the underlying problem by correcting the subcutaneous deficiency.

The most effective treatments for improving under eye circles depend on the individual, but usually the safe, reliable, and recommended solutions that work best are either a midface lift or undereye Restylane.  The midface lift addresses severe structural concerns and returns sagging tissue to its natural, youthful position, successfully treating the under eye bags and restoring balance to the face.  Restylane under the eyes is a facial filler that corrects the tissue deficiency, and it’s a great option for those with a less pronounced problem or who may not be ready for surgery for personal reasons.  The Restylane filler allows the skin associated with the dark circle to drape differently and this greatly improves how light interacts with the lower eyelid lessening the appearance of the dark circle.

How can Dr. Steinsapir help?

Dark under eye circles are one of the most common concerns that Dr. Steinsapir treats.  His practice is one of just a few in the world that makes the treatment of under eye hollows a major focus of specialization.  Dr. Steinsapir pioneered the midface lift with a hand-carved orbital rim implant, and he also invented the patent-pending treatment method Deepfill Restylane, both of which are impressive and respected solutions for correcting under eye deficiencies.  As a leading expert in cosmetic procedures to address the undereye hollow.  He is a noted lecturer and writer on this subject.  He believes in developing an individualized treatment plan for each individual based on minimally invasive methods with safe and proven results.  Please contact us today to find out how Dr. Steinsapir can correct underlying problems and help you restore your vibrant, youthful appearance.

May 12, 2010

Should I Get a Midface Lift or Under Eye Filler?

Filed under: Cosmetic Surgery,eyelid filler,facelift alternative,facial cosmetic surgery,facial fillers,midface surgery,Restylane — Tags: , , , , , — admin @ 10:58 pm

If you are seeking to improve your facial appearance by restoring it to a natural, youthful, and alert look, do not overlook the important difference that midface improvement can make.  When the malar fat pad descends on our faces, it shows up in our midface – the triangular area on each side of the nose.  This can translate to a loss of volume, hollow eyes, and a tired, haggard look.  When there are multiple procedures that can address similar issues, it can be hard to know which one to choose.  These are the times when it is especially important to choose an experienced specialist to aid you in your treatment decisions.  A cosmetic surgeon who has extensive midface experience will be able to give you the best results regardless of what treatment method you go with, which is why it’s always much better to seek guidance from an expert rather than choose a procedure based on what you find online and then use a doctor whose specialty lies elsewhere.

Midface Lift Before and After Photo

Midface Lift Before and After Photo

Dr. Steinsapir almost always recommends choosing the least invasive option that addresses your needs, which of course is different for everyone.  Often patients seeking a midface lift consultation only need Deepfill Restylane treatment, which is a detailed precise technique that requires great skill yet is minimally invasive, offers little to no downtime, and provides great results in the under-eye and midface areas.  At other times when the loss of soft tissue or deficiency in bone projection is profound, Dr. Steinsapir recommends midface surgery, which creates dramatic and long-lasting results.

Benefits for Your Whole Face

Many people don’t realize the extent to which their drooping midface and loss of skin elasticity affects their eyes, which are the focal point of the face.   The midface descent and sagging skin detract from our eyes significantly, causing hollow undereyes and lower eyelid concerns.  Restylane can address the hollow undereyes, but in cases where midface descent is severe, a midface lift is indicated to restore balance.  You may be surprised by the facial improvement possible with a midface lift.

Midface Lift or Restylane?

If you and your doctor opt for Restylane filler treatments, you will need to go in for more treatment periodically, perhaps once a year.  This is a great solution for those who need treatment but do not have severe issues.  You may benefit from a midface lift down the line but only need Restylane right now.  This all depends on the individual.

The midface lift is useful for more dramatic concerns by successfully addressing the way the descent of the midface dynamically impacts the rest of the face.  A midface lift can correct deficiencies like the undereye hollow and even address wrinkles, taking years off your face and helping you to feel better.

Ultimately, you cannot determine your solution until you seek professional advice and receive an examination to determine your needs.

A Midface Lift Pioneer

Dr. Steinsapir is an expert in the midface lift in Los Angeles.  This procedure has been relatively new over the last twenty years, and Dr. Steinsapir has been at the forefront of its study, development, practice, and perfection.  There are a number of midface lift techniques including the arcus marginalis release, tailored lower eyelid surgery combined with reinforcement of the orbitomalar ligament, and the vertical midface lift.  Dr. Steinsapir’s approach is to tailor your treatment depending on your unique condition, facial anatomy, and goals.  He has innovated new approaches and is widely renowned for his reconstructive midface surgery to fix prior failed surgeries. His solutions include minimally invasive techniques, short midface lift recovery time, and his acclaimed approach of using hand-carved ePTFE orbital rim implants.

Dr. Steinsapir will personally perform all your treatment and never relies on assistants or technicians to perform your treatment.  He will work with you closely and keep communication open, so you will not run into any surprises.  At a personal consultation he can answer your questions and give you advice based on your individual circumstances.  Contact us today to find out how a midface lift or Restylane in Los Angeles can help you achieve the results you desire.

March 25, 2010

My eyelids are irregular from surgery. Can fillers help me?

Filed under: eyelid filler,Eyelid Surgery,fixing eyelid surgery,irregular eyelids,Restylane,restylane in los angeles,Restylane Injections — Tags: , , , , , , , — admin @ 11:14 pm

Under normal circumstances, if you have carefully chosen your eyelid surgeon and made responsible decisions regarding your cosmetic treatment, you are likely to have an excellent eyelid surgery result.  However, if you experience a problem after surgery, we recommend you contact your original surgeon, who will probably be eager to help you resolve the issue.  Things do happen that lead to unsatisfactory results.  That is the reason your surgeon spent time reviewing the risks, benefits, and alternatives to surgery and why you read, agreed, and signed an informed consent document for surgery that discussed these possibilities.  Many of these issues can be remedied by your surgeon without the need to get a second opinion.  Many of these issues get better as the surgery heals over time.  However, in cases when the relationship between the patient and doctor has broken down, or in instances when the skill required to correct the eyelid may surpass the expertise of your doctor, it is wise to seek a second opinion.

Whether you consult your original eyelid plastic surgeon or a new physician, if you are experiencing eyelid surgery complications or irregularities such as bumps or hollowness, you should bring up your concerns.  While correcting irregular eyelids is a challenge, eyelid cosmetic surgeons like Dr. Steinsapir who specialize in fixing eyelid surgery can often greatly improve your results.

The solution, of course depends on the specific nature of your problem.  If you’ve been following our blog, then by now you should know that it is our philosophy to completely customize every treatment to the unique surrounding circumstances and the needs of each particular patient.  So it’s a given that exactly what will help your unique case cannot be determined with certainty until your private consultation.  In the meantime, we are happy to give you some informative guidelines.

When are fillers helpful in correcting eyelid surgery?

Here are two examples of when an eyelid filler can help resolve your post-surgery eyelid irregularities:

•    If you have lumps and bumps in the treated area, the filler Restylane may be a great option in smoothing and correcting the area.
•    If you have a volume deficit (perhaps because too much fat was removed), Restylane can fill in this area and restore a healthy, full, youthful appearance.

In the first situation, perhaps you had a procedure like a fat transfer to your lower eyelids.  Fat transfers to the face are an amazing treatment option when the fat is placed somewhere where it can “hide” behind an already-existing layer of fat.  When it is transferred to the eyelids and surrounding areas, however, it can sometimes show up in the form of lumps and bumps because there is not enough tissue here for the fat transfers to hide behind.  Treatment here is difficult because the lumps usually are not in ideal or standard surgical planes, and because using steroids to melt fat is not always predictable.  This is where Restylane comes in.  After the worst of fat deposits are removed, the rest can be filled around with Restylane to give a smooth appearance by using a safe and effective treatment method.  In some cases, Restylane on its own may be sufficient to correct the irregularities and surgery is not needed to remove the larger lumps.  This is great news for those who are apprehensive about undergoing further surgery.  While corrective eyelid surgery is beneficial when performed by a qualified, experienced oculoplastic surgeon who specializes in fixing eyelid surgery, we understand that you may not be ready for surgery.  Nonsurgical Restylane can help.

In the second situation, Restylane can be used to fill the undereye hollow and correct deficits as it is used in other circumstances unrelated to surgery.

Restylane Is Best for Treatments around the Eyes

Restylane and eyelids are so compatible because Restylane is smooth, flexible, safe, and presents itself remarkably naturally around the eye.  Restylane has long-term benefits, but it is also easily adjusted in case the first treatment is not exactly what you want.  These characteristics are essential in the eyelid and surrounding areas.  The skin here is very thin and the tissues are very sensitive, so even small mistakes show up her.  Restylane has proven itself again and again to be the optimum choice here.

Consult with the Best

Very few doctors make undereye and eyelid fillers a major focus of their practice.  Dr. Steinsapir saw a need for specialization here because the eye area is so sensitive to subtleties of treatment yet also crucial to our appearance.  Dr. Steinsapir’s focus on treating the eyelid and undereye hollow led him to innovate Deepfill Restylane, treatment that delivers superior results.

If you have had eyelid surgery and are unhappy with your results, please know that Dr. Steinsapir frequently provides a second opinion and often assists in rebuilding the relationship with your former surgeon.  In cases where this is not the best idea, he helps you to form a treatment plan if treatment is necessary.  Dr. Steinsapir specializes in resolving eyelid surgery issues can help you determine if Restylane in Los Angeles is the best option for resolving your unique needs.  Please call us today for your no-risk consultation, and find out what difference an experienced and caring doctor can make.