FOURTH QUARTER 2007, VOLUME 21, NUMBER 3

Ask the Surgeon | What’s New | Health Tip

IN THIS ISSUE

Achieving the perfect pouty lips … your filler options

Controversies in facelift surgery, your options, what’s new, and what works for you

Ask the Surgeon / Health Tip / What’s New

Recapture your summer glow with a peel

ASK THE SURGEON

I have reddish-purple spots on my face that seem to becoming more noticeable as I age. Is there a way to make my skin appear more even?

Yes, there are several options that may reduce the appearance of the spots on your face. Two possible solutions are camouflaging or laser resurfacing. Your facial plastic surgeon will help you choose which treatment is best for your skin.

You can camouflage your blemish with a concealer or a color corrector. Concealers work well to mask discolorations. Choose a product that is hypoallergenic, fragrance free, opaque, and waterproof. Color correctors are not as opaque as concealers and come in tints; e.g., a green corrector would reduce the reddish-purple appearance of your spots.

Your surgeon may recommend laser resurfacing. This would remove the epidermis (outer layer) of your skin and allow a new, supple skin to emerge. Lasers work by producing a powerful beam of light that gently removes the skin tissue. The depth of laser resurfacing depends on the type of laser, wavelength, power, and pulse direction. Slight pigmentation problems generally originate in the epidermis, which can be penetrated by the laser. After resurfacing, during the repair process, your skin rebuilds the tissue allowing a fresh new layer to emerge. Laser resurfacing is a good option for improving uneven pigmentation.

HEALTH TIP

There are new products, procedures, and techniques popularized in the media everyday. It is very important to seek the advice of your facial plastic surgeon before committing to the latest trend—especially when it comes to a product that has not been approved by the Food and Drug Administration (FDA). For example, a recent article in the Washington Post discussed Lipodissolve™ as an alternative to liposuction.

There are no standards for the mixture of phosphatidylcholine and sodium deoxycholate—i.e., the ingredients and strengths that make up Lipodissolve may vary. Also, it has not been approved by the FDA. More studies must be performed; therefore, patients should be cautious.

WHAT’S NEW?

ArteFill® is a combination of collagen and acrylic beads that stimulates the skin to make its own collagen. It is the first and only non-resorbable aesthetic injectable implant approved by the Food and Drug Administration for the correction of nasolabial folds (marionette lines). The results are permanent.

ArteFill is injected into the deep dermis, using a threading technique. There is no pain or discomfort to the patient due to the lidocaine within the solution. However, patients must be tested for collagen allergies before using the product. ArteFill® is an improved version of its predecessors, ArteColl® and ArteFast®.

 

Limited incision facelifts

The following procedures-S-lift, J-lift, and short scar facelift-minimize the incision length. The advantage may be a shorter recovery. The disadvantages of a limited incision facelift are that it may not last as long and the change may not be as dramatic as from a traditional procedure.

The S-lift derives its name from the "s" shape of the excision used near the ear. A technique involving suturing of the SMAS and the ESP (extension of the supraplatysmal plane) to the perosteum and zygomatic bone is used. This means that the fixation of the soft tissue to the cheekbones provides stability as well as fullness to the area.The S-lift is not as invasive as the full facelift, therefore, there is less procedure time, lower cost, and quicker recovery. This lift is best for those who have early or minimal aging changes.

The J-lift is a procedure that lifts and firms the lower one-third of the face and neck. Its name comes from the area that is corrected by the procedure, the jaw line or jowls. By repositioning of the muscle groups underneath the surface, the jowl is lifted to its natural best site for beauty. The incisions are hidden.

The short scar facelift has an incision length half the size of a traditional facelift incision. This makes the procedure less invasive. This lift repositions the skin and soft tissues of the face that have been affected by the aging process, with the principle difference being minimized scarring. Unfortunately, not all patients are good candidates for this technique; patients with excessive skin around the neck would benefit more from a traditional facelift.