July 15, 2011

What should I expect with my BOTOX treatment?

There are a lot of different rumors out there about what you can expect from BOTOX®,  Dysport®, or other botulinum toxin A injections; rumors about harmful side effects, who is qualified to perform the injections, and long recovery periods.  The truth is, BOTOX injections have an amazing track record for safety and  require little to no down time.  The results last from 4 to 6 months before you may feel the need to freshen your appearance.  Receiving BOTOX relaxes your facial muscles to remove crows feet, lines in your forehead, and that angry pinch at the eyebrow that robs you of a more youthful, relaxed, and friendly appearance. There is no substitute for having a leading authority in cosmetic surgery personally perform your service.

Where is surgery commonly performed?

BOTOX injections are an office-based service. You may see estheticians and unqualified individuals like medical assistants offering injections illegally in spas and salons under the justification that they have a “medical director.”   There are no states that permit this arrangement.  Unless a doctor is present and performs the service, this type of situation is the illegal practice of medicine.  Don’t let an unqualified individual perform your BOTOX or Dysport service.

Only a licensed medical doctor or a nurse under the direct supervision of a licensed medical doctor can inject BOTOX.  The exact details of the required qualifications vary by State so it’s important to research the individual you wish to perform the injection to ensure he or she is qualified.  However, just because your doctor or nurse is minimally qualified to perform the injection does not necessarily indicate he or she is the ideal choice for the procedure. As with many other medical procedures, the best results require a certain level of qualification, skill and experience; these concerns are perhaps even more important when considering modifications to your physical appearance.

What is the typical recovery course and physical restrictions?

BOTOX injections may cause a little bruising from the treatment and you may notice redness in your skin for an hour or two. Many people find that they can return to work immediately after treatment.  Others find that they like to apply a little ice to the injection points before facing work again.

Although you can return to your usual routine following treatment and may feel physically ready to take on the world, Dr. Steinsapir strongly advises you refrain from exercising and engaging in strenuous physical activity for at least 24 hours.

What are some common complications after a cosmetic botulinum toxin treatment and how are they addressed?

Many prospective patients worry about side effects or potential dangers of Botox® injections.  In the case of BOTOX® and Dysport®, the FDA issued a “Black Box Warning” in 2009 because there was concern regarding a rare but potentially fatal complication when they are used to treat very small children with cerebral palsy.  The dose used for these medical treatments can be 10 or more times higher that what is used for cosmetic purposes.  More information regarding these issues can be found here.

“Dose is very important in the safety of all drugs, not just BOTOX® and Dysport®” says Dr. Steinsapir a leading authority, teacher, and much sought after BOTOX® injector.  Even the safety of aspirin, which is present in almost every American household, is dependent on dose: two aspirins helps your headache feel better, but 20 aspirins are poisonous..

Many unwanted results like the BOTOX forehead freeze, droopy eyebrows, the appearance of the eyes being smaller, and the “bat-face” caused by muscle recruitment in areas of the face that have not been treated, are the result of physicians injecting BOTOX incorrectly.  Carefully researching your chosen physicians credentials and experience can greatly reduce the risk of one of these side effects.

An innovative alternative

Dr. Steinsapir has invented Microdroplet™ BOTOX® to address the need to retain authentic facial expression and natural eyebrow placement. Unlike standard BOTOX® procedures, Microdroplet™ BOTOX® creates brow lift without forehead paralysis. If you have had BOTOX® treatments in the past but were not satisfied, Microdroplet™ BOTOX® may give you the results you need by working with greater precision with your facial muscles. The care and interest Dr. Steinsapir has shown in inventing this treatment demonstrates his dedication to achieving a beautiful, more youthful appearance without impeding the ability to express emotion.

Using standard injection methods, there is no way to selectively treat the muscles that pull the eyebrows down.  Instead these methods tend to freeze the forehead.  Perhaps you have experienced these types of results yourself or have seen them in your favorite actresses: The forehead can’t move and the eyebrows drop like stones.  What looks good is a gently lifted eyebrow, no crows feet lines or brow pinch, and a forehead with reduced lines that is still able to move.  Imagine a BOTOX® treatment that allows you to have natural expressions!

About Dr. Steinsapir

Dr. Steinsapir trained alongside the inventor of BOTOX and has performed thousands of BOTOX treatments in Los Angeles since 1988 and recently patented his Microdroplet BOTOX technique. He is a board certified eye surgeon and fellowship trained in oculoplastic surgery and cosmetic surgery in Southern California where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology.  Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in BOTOX, which can be a vital part of your evidence-based treatment plan.

Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment.  No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success.  Only you and your treating physician or surgeon can determine if a treatment is right for you.

July 14, 2011

Facial Sculpting with Microcurrent

Microcurrent facial sculpting is a rising trend, but buyer beware the cosmetic surgery fads.  Like lasers, the term “microcurrent” sounds sexy and high-tech.  But the reality of microcurrents is that they are a lot of hype and very little science.  The use of microcurrent devices is essentially unregulated.  FDA clearance of these devices is very simple for the manufacturers because the amount of current used is so small.  The marketing for microcurrents would have you believe that by stimulating your facial muscles, your face becomes more toned and appears lifted and more youthful.  There is no evidence that this is true.

The Truth About Microcurrents

Quacks have been touting the value of electrical current for healing for about as long as man has controlled electricity.  Obviously, high voltage, high amperage devices are dangerous.  What we are talking about here is very low levels of electrical current.   Remember the adage that every good lie begins with a grain of truth.  It is easy to understand that if you lift weights consistently enough, the muscles become toned.  Proponents of microcurrent devices make the argument that the electricity of these devices will stimulate and tone the facial muscles and this will tone and improve the face, getting rid of wrinkles at the same time.  Sounds great.  The only problem is that there is not a single scientific study that supports this idea.   We call this “phony science.”  Microcurrents cannot, and will not lift and reposition the facial tissues.  Even the claims of mild improvement are unproven.  The harm here is that you are wasting your time and money and being deceived in the process.

Why all the Hype?

The hype surrounding microcurrent facial sculpting machines with unrealistic before and after pictures are equally misleading.  Typically these before and after pictures show a loose neck and jowls next to a youthful and sculpted jawline and neck.  These pictures could show the same person, but it is unlikely the differences were the result of microcurrent facial sculpting.  The smooth, wrinkle-free neck is most likely the result of a little Photoshop magic and lighting, not microcurrent.  These treatments offer empty promises.   The treatment does not compare to a facelift or nonsurgical facial fillers.

About Dr. Steinsapir

Dr. Steinsapir is a board certified eye surgeon and fellowship-trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in cosmetic surgery, which can be a vital part of your evidence-based treatment plan.

Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.

February 27, 2011

Can I exercise my facial muscle for an improved tone?

Exercise and diet are essential for a healthy lifestyle, but it’s important to recognize their limitations.  Not every condition can be cured by exercise, vitamin supplements or fad diets, especially when the problem is not a result of poor nutrition or inactivity.  We absolutely encourage you to exercise moderately and eat well, but we admit to being skeptical of the arising claim that exercising facial muscles can restore youth and beauty to one’s face.  This is an unproven method, and when one considers that they are likely still using their facial muscles just as much as they were ten years ago, it becomes apparent that their aging looks are unlikely due to facial inactivity.

It’s appealing to believe that we can resolve all of our concerns through exercise, and while research shows that exercise does benefit our health in many ways, it also shows that further medical treatment is required for many conditions.  Just as someone with presbyopia cannot exercise to regain the ability to focus for reading vision, it’s not likely that you’ll be able to reverse the effects of age, time, gravity, and stress by wiggling your face or by having electrical currents stimulate your facial muscle to contract.

There are many types of facial cosmetic surgery and other treatment that can help you obtain the result you need if your doctor determines that you are a suitable candidate.  These range from minimally invasive treatments with little-to-no downtime like BOTOX and undereye Restylane to surgeries like the facelift and plastic eyelid surgery including eyelid reconstruction, which give dramatic yet natural results to individuals with far-reaching concerns.  While it is impossible to know which treatment, if any, is most suitable for you before a private consultation with the best facial cosmetic surgeon for you, you can be confident that there are a wide range of treatments that an expert can custom-tailor to meet your needs.

As a specialist in facial cosmetic treatments, Dr. Steinsapir has treated many individuals who first explored a variety of “natural solutions” for their aesthetic facial concerns.  Frustrated when they saw no results, they eventually consulted with Dr. Steinsapir and opted for proven treatment methods that provide dramatic yet natural results.  This human tendency to pursue unproven treatments is not a fault; it is normal to want to independently resolve a problem using the least invasive and most economical method possible.

Dr. Steinsapir is focused on your personal goals and comfort level.  Dr. Steinsapir always asks you questions about your specific goals, individual situation, and preferences so that he can plan a solution that is aligned what you want, so you can feel comfortable knowing that you are ultimately in control of your treatment plan.  Dr. Steinsapir very much believes in using the least invasive method for accomplishing a particular goal; for example, he does not recommend a forehead lift when a BOTOX treatment for wrinkles will will meet your goals – and he is a leader in his field of minimally invasive solutions.

If you are seeking a proven treatment with an experienced facial plastic surgeon with extensive training in oculofacial plastic surgery, we invite you to a personal consultation with Dr. Steinsapir today.  Dr. Steinsapir is honest, friendly, and can talk to you about customized treatments that give you the results you seek by addressing your specific needs and unique facial features.  Please call us today to schedule a time when you can speak with Dr. Steinsapir.

About Dr. Steinsapir

Dr. Steinsapir is a board certified cosmetic surgeon and oculoplastic surgeon in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology.  Dr. Steinsapir has a private practice and also serves patients at UCLA, where he is an assistant
clinical professor. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert provider of facial cosmetic surgery and eyelid reconstruction, which can be a vital part of your evidence-based treatment plan.

January 14, 2011

Dr. Steinsapir’s Microdroplet™ BOTOX® Patent Officially Approved

The United States Patent and Trademark Office has officially issued a rare patent (US 7,846,457 B2) to Dr. Kenneth D. Steinsapir for his Microdroplet™ botulinum toxin (BOTOX®, Dysport®, Xeomin®) method.  The Microdroplet method of administering cosmetic botulinum toxin is a breakthrough invention that revolutionizes the way we think about BOTOX® treatments.

Microdroplet BOTOX Before and After Photo

Microdroplet BOTOX Before and After Photo

Microdroplet™ BOTOX® is an enhanced and now-patented method of administering cosmetic botulinum toxin, most commonly referred to simply as BOTOX®, to individuals who seek cosmetic facial improvement with minimal risk of side effects.  To achieve natural results without the “bat face” or “forehead freeze” sometimes associated with BOTOX®, Microdroplet™ BOTOX® relies on highly controlled placement of tiny microdroplets of botulinum toxin to balance out the give-and-take of the muscles pulling around the eyebrows and causing the all too familiar pinching and frown lines.

What are the benefits of Microdroplet™ BOTOX®?

The result of the precise and balanced placement of your Microdroplet™ BOTOX® treatment is that you can attain natural-looking results that balance your facial features while avoiding the side effects that we more often see with traditional BOTOX treatments.  While there is a chance with any cosmetic procedure that you will not be completely satisfied with your results, Microdroplet™ BOTOX® can maximize your chances for an ideal outcome by relaxing overactive facial muscles and emphasizing your youthful features.

Who is a candidate for Microdroplet™ BOTOX®?

Microdroplet™ BOTOX® is especially recommended for high-profile professionals such as executives, actors, and other individuals who seek a polished aesthetic during their daily interactions with people.  Microdroplet™ BOTOX® preserves natural forehead movement and expression without the all-to-familiar frozen appearance that has become the hallmark of getting treatment with BOTOX® using traditional injection methods.  The relaxed and lifted eyebrows with preservation of forehead movement sets this treatment apart form other methods and has made Dr. Steinsapir’s office the place to go for the most exclusive BOTOX® treatment available.  Those who wish for a younger look with reduced wrinkles, frown lines, and crows feet will want to checkout Microdroplet™ BOTOX®.

How was Microdroplet™ BOTOX® invented?

Dr. Steinsapir has been administering BOTOX treatments since 1988, and he explains, “Early on I recognized the need for an improved approach to cosmetic treatment by carefully listening to the concerns of my patients.  Natural outcomes are vital to a successful and satisfying cosmetic treatment experience.”

In his search for the best treatment, Dr. Steinsapir observed and listened to his patients before and after their BOTOX treatment, and from there he carefully researched and innovated the now-patented Microdroplet™ BOTOX® method in 2006.  Dr. Steinsapir adds that “Microdroplet BOTOX can improve the appearance because it works on select muscles to attain and improve overall facial balance.  It’s an important option for individuals who seek cosmetic improvement without surgery and an essential alternative to current treatment methods.  There is little doubt that this new method will become the predominant method for administering botulinum toxin.”

Who is authorized to provide treatment with Microdroplet™ BOTOX®?

At this time Dr. Steinsapir, the inventor of Microdroplet™ BOTOX®, is the only individual who performs Microdroplet™ BOTOX® treatment.  Dr. Steinsapir is a board certified ophthalmologist specializing in oculofacial and cosmetic surgeon, and an associate clinical professor of ophthalmology at the David Geffen School of Medicine at UCLA.  His practice is located in Beverly Hills, California, and individuals fly here from across the United States and world to benefit from his exceptional patented Microdroplet™ BOTOX® as well as expertise in other minimally invasive cosmetic facial treatments.  For more information on how Dr. Steinsapir’s innovative, forward-thinking treatments focused on natural results can help you, please contact us today.

August 29, 2010

Do stem cell facelifts work?

“Stem cell facelift” is just a fancy name for fat grafting. Since fat from our body does contain stem cells, a fat transfer to the face for a facelift or other facial cosmetic surgery can technically be said to include stem cells. However, suggesting that these so-called adult stem cells are the reason that a fat transfers work is a huge leap.

Marketing Based on a Grain of Truth

It is said that most good lies are based on a grain of truth. After all, mingling fact with fabrication is an effective, if not questionable, method of convincing an audience. If part of something is true then how is a non-specialist to discern where the truth ends and the exaggerations begin?

Here is what’s true: The “stem cell facelift” being marketed today is the same process that goes by the medically accepted names of fat grafting, fat injections, and fat transfers. This is a process in which fat is harvested from another area of the body such as the thighs or tummy, often improving that area’s shape, and then grafted into a deficient area like a hollow cheek to provide a natural filler. This is a biologically safe procedure because the fat transferred is your 100% match, and it is precisely delivered through a tiny poke in the skin that heals without scarring. The fat transfer in a “stem cell facelift” may be combined with other procedures like a traditional facelift or midface lift, in which case we’d rather be straight forward and say “facelift with fat grafting.” This is a more direct description.

This is also true: The stem cells in our body fat can be separated from the fat and, in a test tube at a research lab, be stimulated to develop into other cell types. There is a lot of impressive research being done in this area so we can learn more about important potential medical uses of stem cells. But do they really play any role in a facelift?

The Real Benefits of Fat Grafting

So, yes, when we transfer fat to the face we do transfer some stem cells with it. However, there just isn’t evidence to suggest that stem cells are what make fat grafting and “stem cell facelifts” work. The reason they work is because much of the transferred fat – about 60-70% – survives, creating long-lasting benefits.

The overall distribution of fat over the body is very important. Too little or too much does not look good. The most common problems with fat distribution is too much in areas like the hips and too little in parts of the face. This means that we may look bottom-heavy while haggard in the face. Fat harvesting can improve an area that is too full, and the harvested fat can then be grafted into tissue-deficient regions. When carefully placed, the added facial volume creates a naturally soft appearance associated with youth, correcting the volume loss many of us experience as we age.

Honest Medicine for Best Results

Our concern with the “stem cell facelift” is not that it’s a bad procedure, but rather that this is not the most accurate description. Some professionals even feel that calling fat grafting a “stem cell facelift” is misleading. When seeking treatment, make sure that your potential cosmetic surgeon relies on science, experience, and skill rather than catchy marketing phrases. Your doctor should be a specialist in facial cosmetic procedures and completely honest about what a treatment does and does not do.

Dr. Steinsapir is among the top cosmetic surgeons in California. He is multi-fellowship-trained in both cosmetic and oculofacial surgery with special emphasis in natural results and fast recovery time. Dr. Steinsapir is straightforward, helping you understand the benefits of treatments you’re considering without any frills or exaggerations. You’ll also find that Dr. Steinsapir is friendly and caring. Because he individualizes each treatment plan based on your personal needs and unique circumstances, you can achieve results that are right for your features. Contact us today to learn more about how fat grafting, a facelift, or another treatment can improve your facial contour.

August 24, 2010

I Want to Improve my Looks Before Reentering the Workplace…

I Want to Improve my Looks Before Reentering the Workplace… What does Dr. Steinsapir suggest?

Congratulations on your decision to go back to work!  You have a lot to contribute.  But let’s face it, it is a competitive, youth-obsessed world out there.  They need your skills but there is such a premium on youth that more experienced executives can be passed over.  There is no question that cosmetic treatments and surgeries can enhance your appearance and enhance your competitive advantage in the workplace.  These improvements will boost your self-confidence and allow you to project energy and authority.  So let’s consider a few ways you can make your transition back into the work world as smooth as possible.

We cannot prescribe a set of procedures or lifestyle changes that everyone returning to work should follow.  You won’t find a “blue plate special” here with a prescription for all readers to get a Beverly Hills facelift with the works.  Minimally invasive services like BOTOX, Restylane, and facial liposuction can make a world of difference with little or no surgery.  What may be right for someone else is not necessarily ideal or even desirable for you.   Regardless of your career path, your treatment needs will depend on your unique circumstances, physical features, medical history, and personal goals.  What we can suggest are some good ways to decide what to do next.

Determine Your Goals

Think about your goals as you return to work.  You want to improve your looks, and this can take many forms.  Ask yourself what specifically you want to improve about your looks and how you want this to impact your professional life.  For example, you may want to look healthy and vibrant; improving your diet, work out routine, and making changes like finally quitting smoking can help you look trim and improve your health.  You may want to convey personal style that can fit into a serious corporate environment; in this case you could change your wardrobe by adding some new suits that flatter you and command respect.  You may wish to look energetic and youthful; correcting wrinkles and restoring your face’s youthful beauty through cosmetic treatment may help you to feel confident and help others recognize that you have a lot to offer.  You don’t want to look as if you are unhealthy, cannot dress the part, or are about to fall asleep from fatigue or stress.

There are many effective ways to improve your looks, and you’ll likely want to pick a combination of image-enhancing changes.  This could mean that you need to hit the gym and switch to a makeup that better matches your complexion.  It may mean that you need to lose ten pounds, have your teeth professionally bleached, throw out the slacks that no longer convey your personal message, and correct the dark circles under your eyes with Restylane.  Think about what you need to improve, and start there.

Cosmetic procedures are an important option for many who seek a more professional appearance and increased confidence.  Many find that others view them as more capable because they don’t look exhausted, aged, or upset from the toll that age, gravity, stress, and sun damage take over time.  Depending on your situation, a facelift may balance your features, BOTOX may erase worry lines, a chemical peel may rejuvenate your skin, or an eyelid surgery may correct ptosis.  The only way to know for sure is to consult with one of the best cosmetic surgeons.

Transitioning to Your Professional Face

Many people find that, as they return to work, looking forward to the upcoming changes gives them the motivation and drive they need in order to meet their appearance-oriented goals.  You might discover new motivation to make healthy changes in your eating habits, find a fantastic outfit for interviews, and begin a cosmetic treatment plan soon so you are ready to make a great first impression.  Whatever the best options are for you, we advise you to apply your motivation and enthusiasm into both your job preparations and your professional look.  Make taking care of your appearance and your health a regular part of your new lifestyle.

There are many cosmetic treatment options that require little-to-no downtime, and you can often return to work the next day or take a long weekend.  This depends on the procedure, your healing, and your treatment plan.  Dr. Steinsapir focuses on minimally invasive procedures that give you the most benefit for the least downtime.  He aims to have you in social situations as quickly as possible, with a swift recovery time and natural results.  For example, many who choose facial liposuction with Dr. Steinsapir have it on a Thursday and return to the office on Monday, and nobody is even aware that they had surgery; they just assume that their colleague is losing weight and feeling brighter.  On the other hand, if you are seeking a facelift – perhaps the single most powerful facial surgery for improving one’s appearance – you may need to allow adequate recovery time, depending on the procedure, your job, and your facelift recovery.  In these cases, it is wise to consider seeking treatment today so you can be ready to go back to work at the end of your healing period.

Consult with the Best

Dr. Steinsapir practices medicine at both UCLA and in West Los Angeles, where he specializes in facial cosmetic surgery and oculofacial plastic surgery.  Because of his specialization in minimally invasive facial procedures that emphasize fast recovery and natural results, Dr. Steinsapir has an exceptional understanding of the complex ways each part of the face influences and interacts with the other parts, enabling him to customize each treatment for the individual.  He has extensive experience in treatment and research, as well as a prestigious educational background at the David Geffen School of Medicine at UCLA, The University of Chicago, Jules Stein Eye Institute, and other fellowship training.  Dr. Steinsapir is a forward-thinking leader in facial cosmetic treatments who has developed Deepfill Restylane and the patent-pending Microdroplet BOTOX procedures.  If you want to add more confidence to your career decisions, contact us today to see how a consultation with one of the best professional cosmetic surgeons can help you attain your best professional appearance.

August 2, 2010

What are the best lasers to improve my dark circles?

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.

July 6, 2010

Are there any reasons why I should avoid BOTOX or Dysport?

BOTOX is a nonsurgical cosmetic treatment that has been proven to be both effective and medically safe.  Millions of people enjoyed treatment with BOTOX and Dysport, another botulinum toxin A product, last year to improve their cosmetic concerns.

Microdroplet BOTOX Before and After

Microdroplet BOTOX Before and After

However, this does not mean that BOTOX is the right choice for everyone, and this is a decision your doctor can help you make.  The short answer to “Is there any reason to avoid BOTOX?” is that it is extremely unlikely that you will experience any complications from BOTOX, and given the temporary nature of the treatment, you needn’t worry that your looks will be changed permanently; on the other hand, side effects can occur even if you are treated by a highly qualified injector.  It is also reasonable to expect that side effects will be more likely when treatment is performed by relatively inexperienced injector.

Are BOTOX and Dysport safe and effective?—absolutely.  But like every medication, these drugs need to be used in an expert fashion, which includes knowing when treatment is not appropriate.

New Black Box Warning for BOTOX

The FDA has recently required the manufacturer of BOTOX, Allergan, Inc. and the distributor of Dysport, Medicis, Inc. to include a special health warning regard the use of these drugs, which both contain botulinum toxin A as the active ingredient.  Experience with these drugs since they were approved has demonstrated these drugs to be very safe and effective when used in the small doses needed for cosmetic treatment.

These drugs are also used for medical purposes in much higher doses.  At these higher doses, there have been serious side effects leading to the new FDA warning regarding systemic or so-called spreading effects.  Specifically, larger doses of either of these drugs can cause systemic side effects including a generalized weakness, medically referred to as asthenia, double vision, blurred vision, eyelid droopiness, difficulty swallowing, difficulty breathing, difficulty speaking, and urinary incontinence.  Note that droopiness of the eyelid and double or blurred vision is possible, though fortunately rare, if cosmetic treatments spread to other parts of the face.  Breathing and swallowing difficulties can be life threatening and have contributed to death in already very sick individuals in the treatment of medical conditions.  It is thought that very high doses of these drugs used to treat certain medical conditions in small children present the greatest risks.  Individuals with life threatening heart conditions should also be treated with caution.

No definitive systemic side effects have been reported for the doses typically used for cosmetic purposes or for treating excessive sweating in the armpit area.  However, certain precautions seem reasonable even for cosmetic use.

If you have had any prior episodes of any of the systemic side effects described above, you should advise your doctor and not accept additional treatment with any botulinum toxin agents unless it is for medical purposes and your treating physician and you agree that the potential treatment benefits out weigh the adverse side effects.  If you are not sure, discuss your prior reactions with your doctor.  Although, quite rare, if you have a known allergic response or hypersensitivity to any botulinum toxin preparations it is advisable to avoid these treatments in the future.

It is your responsibility to be completely honest with your doctor about your medical history and anything that may affect your treatment.  BOTOX has a great track record for safety in both clinical studies and in practice, helping to relax select facial muscles at the eyebrow and restore a more youthful appearance.  While systemic side effects of these drugs probably occur even for cosmetic treatments, these effects must be very rare or mild.  But for this reason, there are a few instances when BOTOX should be avoided.

If you are pregnant or breastfeeding, you should not be treated with BOTOX or Dysport.  There is a very small study of women who were treated with BOTOX while pregnant with no problems, but this is not enough evidence to state that BOTOX and Dysport are safe during pregnancy or while breastfeeding.  What should you do if you discover you were pregnant when you received BOTOX?  Don’t panic. While this practice is not recommended, this single study suggests that the exposure may be safe enough that there may be no reason for action.  However, it is recommended that you see your gynecologist/obstetrician for personalized care recommendations. For the same reasons, reputable physicians will not treat you for cosmetic reasons if you are known to be pregnant or breastfeeding.  Treatment with these agents for medical reasons is determined on a case-by-case basis.

If you have a known neuromuscular disease, you should generally avoid cosmetic BOTOX and Dysport treatment.  These are unusual and debilitating health conditions like myasthenia gravis, Lambert-Eaton syndrome, and peripheral motor neuropathic conditions like amyotrophic lateral sclerosis.  If you have an existing difficulties breathing or swallowing, it is important to make your doctor aware of these issues.  Because BOTOX and Dysport treatment could make these conditions worse, it is generally advisable to avoid treatment under these circumstances due to the potential spreading effect of these treatments in higher doses.  Again, no definitive problems have been reported for the smaller doses used for cosmetic treatment, but caution is warranted with these types of medical conditions.

Botulinum toxin products contain a tiny amount of human albumin, a derivative of human blood. Based on effective donor screening and product manufacturing processes, it carries an extremely remote risk for transmission of viral diseases. A theoretical risk for transmission of Creutzfeldt-Jakob disease (CJD) also is considered extremely remote. No cases of transmission of viral diseases or CJD have ever been identified for albumin.

BOTOX and Dysport can be potentiated by aminoglycosides, a type of potent antibiotic, or other medications that interfere with neuromuscular transmission including curare-like nondepolarizing blockers, lincosamides, polymyxins, quinidine, magnesium sulfate, anticholinesterases, and succinylcholine chloride.  If you are using any of these drugs, the effect of the toxin may be potentiated and caution is advised.  For this reason, it is important that you fully discuss with your doctor all medication that you may be using.

If you develop any unusual symptoms (including difficulty with swallowing, speaking, or breathing), or if any existing symptom worsens, notify your doctor at once.  If the symptoms seem serious, call 911 for emergency help and notify your treating doctor when this is convenient.  If you do experience loss of strength, muscle weakness, or impaired vision avoid driving a car or engaging in other potentially hazardous activities and seek medical care.

Very few people reading this and getting BOTOX or Dysport will have any of these issues.  However, if these warnings do apply to you, be honest with your doctor and seek alternatives to these products.

How Individualized Treatment Plans Make All the Difference

The key to effective BOTOX treatment and other cosmetic treatment in Los Angeles is to find a doctor who specializes in the help you need and has experience, education, recommendations, and results to prove that he or she is skilled and the best qualified.  If you are worried because you have heard of unsatisfactory results like the “BOTOX freeze,” you are likely hearing about a few examples of people either going to unqualified practitioners (they may not even be doctors; for example assistants and “physician extenders”).   Just because one of your favorite actors or actresses show up with a frozen forehead, don’t assume that this is a desirable treatment result.  There are great alternative to this type of treatment result.

Seek Help from Qualified Cosmetic Botulinum Toxin Specialist

Only a private consultation with a physician who is fully qualified to administer BOTOX and Dysport will be able to help you understand your best course of action.  BOTOX is a minimally invasive, safe, and effective treatment that helps millions of people each year restore balance to their face.  Dr. Steinsapir is multi-fellowship trained in both cosmetic surgery and oculoplastic surgery, and with many years of practical experience.  He is a Clinical Associate Professor at UCLA and has the practical know-how needed to understand complex facial dynamics and establish unique treatment plans that work.  Please contact us today to find out if you are a good candidate for BOTOX or Dysport treatment.

June 3, 2010

Will nanotechnology make my face look better?

When you are looking for results, seeking out the latest buzz in treatment is not necessarily the option that will yield the best results.  New technologies are new for a reason – they are still being developed and studied, while many less honest marketers piggyback on the work of actual scientists by claiming to use a technology when they really aren’t.  Being one of the first to undergo a treatment is risky; there are basically three things that could happen:

1.    Your results will be as amazing as you’d anticipated.
2.    Your results will be limited, disappointing, or nonexistent.
3.    You may experience negative side effects and complications.

Of course, we all hope for #1 to be us, but since new treatments haven’t had time to be studied, perfected, and tailored to the individual, #2 is more likely.  It’s also possible that the new treatment will harm you in ways that are hard to predict just because we don’t have enough information or experience yet; this could mean you are unlucky #3.

In the case of a cosmetic procedure, a brand-new, unproven treatment probably isn’t the best option.  You are probably better off going with a time-tested, successful treatment like BOTOX, the facelift, or a facial filler.  Many apparently cutting edge technologies that get talked about on the internet or even promoted by cosmetic physicians don’t actually exist.  This is currently the case for Nanotechnology.  It may be fun to speculate that one day, tiny nanobots might treat skin wrinkles from the inside.  However, at present this is the stuff of science fiction.  History has taught use that many of these cutting edge technologies may not prove to be safe and reliable.  Gene therapy is an example of this.  Early gene therapy for infants with severe combined immunodeficiency actually caused leukemia in a very high percentage of  successfully treated infants.  It sometimes makes sense for someone with a terminal condition to participate in new, scientifically-founded research.  However, this calculus does not make sense for someone looking for a cosmetic benefit to their appearance.  At least in a clinical study the potential risks are highlighted and complications are studied.  Unfortunately, this is not always the case with cutting edge cosmetic treatments.  Remember, there are currently many excellent and reliable treatment methods.  Why choose an option that has not stood the test of time or any testing for that matter?

The Concern Raised by Nanotechnology Face Treatments

We are further concerned by claims made by the sellers of products like face creams purported to use nanotechnology to revitalize your face.  We’ve discussed the limited effectiveness of face creams before, and unfortunately the hype about nano-cosmetics may rely more on a buzzword than on science itself.  Producers of a cream or makeup may claim their product works on a nano level because saying they heal tiny particles in our cells sounds pretty good; just don’t equate this claim with current research on nanobots.  We aren’t saying that a nanotechnology face cream will harm you or even that it’s no good; we’re simply saying we’re skeptical when someone asks you to pay $300 on an unproven cream that may have nothing to do with actual nanotechnology research.

One of the great challenges when seeking the best cosmetic treatment is sorting through all the smoke and mirrors, so to speak.  You may need dramatic results, and when everyone claims they have the best solution, how can you know who to trust?  This is why it’s so important to find a qualified physician to answer your questions, assess your situation, and help you navigate trusted scientific resources and proven treatment methods.

Seeking Science-Based Treatment

If you need a cosmetic surgeon in California, we invite you to a no-risk consultation with Dr. Steinsapir, who has extensive training in both oculofacial and cosmetic surgery.  He is a leader in nonsurgical cosmetic procedures like undereye Restylane.  He has been at the forefront of new treatments like the use of hand-carved ePTFE orbital rim implants in the midface lift, and he can help you recognize the difference between promising new treatments and fads.

Dr. Steinsapir relies only on proven treatments that are strongly supported by research and demonstrable results.  Rather than rely on inexperienced assistants, physician extenders, or unproven fellows, Dr. Steinsapir will personally customize your treatment to your particular concerns and goals, and he will administer your treatment himself.  Call us today to see how Dr. Steinsapir can use his expertise in leading scientific treatments to help you get real results.

May 12, 2010

Should I Get a Midface Lift or Under Eye Filler?

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.

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