Cheek augmentation (Cheek implants)

Cheek augmentation can be done using either implants or injections. The implants that may be used are usually made from a solid silicone material. They will not feel soft to the touch (like silicone breast implants) when implanted, and will feel and look like natural bone in the cheeks.

These implants come in various shapes. Malar implants are the most common. 

They will be placed directly on the cheekbones and will result in a more projected appearance to the cheekbones.

Submalar implants are not placed on directly on the cheekbones and are the ideal choice for those patients who want to improve the appearance of their “midface” region. This is great if your cheeks have a sunken in appearance or a permanently gaunt appearance that you would like to get rid of.

The other option is a combination of both the previous types. They will fill in the midface of the patient while also improving the profile of their cheekbones.

The incisions for this procedure are made in the top of the mouth right about at the gum line. The implants will then be slid in to position from below. This method carries some risk of infection since the human mouth has a large amount of bacteria in it. If you are concerned about that, your doctor is also able to make an incision externally instead—it would be placed near the eye, but it will leave a visible scar. Be sure to discuss your options with your doctor if you think you want the external incision option.

One important thing to note with this procedure, is that the implants MAY shift. This could become so bad that it moves up and begins blocking your vision.

If implants are not what you want,  you can always look in to fillers or injectables. Hyaluronic acid compounds, like Restylane or Juvederm can be used—but these are not permanent options. An injection of your fat can be done as well, and would provide a more permanent solution. Choosing injectables over an implant is based on your current appearance and the changes you want to make, so be sure to ask your doctor about all of your options. One great thing about these methods is that there is no scarring and your recovery time will be less than with implants—although cheek implants typically only take about a week to recover from.

Check out some before and after shots to get an idea of what this procedure could do for you:

This is a popular procedure for both men and women. As you can see in these pictures, subtle is best. Both of these patients have a very nice looking bone structure in their after images. You can see the difference the implants have made in the relaxed appearance of the face. These implants will alter more than just your cheeks-- they can make wrinkles less noticable, change the shape of your lips/mouth, and overall restore a more youthful appearance.

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Laser Hair Removal Details- How does it work?

I’ve been getting lots of questions about laser hair removal so I’m going to go a little more in depth about it in this post. If you still need to learn the basics, check out my previous post.

Many people wonder how the laser actually causes the hair to stop growing—it’s simple. The laser emits energy that penetrates the skin and when doing so, will get converted to heat (which is why they always perform laser hair removal in combination with a cooling system of some kind). This heat damages the hair follicle thus preventing the follicle from being able to grow again.

The procedure works best on light skin/dark hair combinations because melanin helps the laser target the hair follicles. Melanin is produced by melanocytes in your skin. The melanin they produce is transferred to the hair follicles, as well as to your skin—this is what is responsible for the coloration of hair and skin. Laser hair removal does not work well with light colored hair because this type of hair does not have much melanin in it and therefore it is tough for the laser to target it. Melanin is also the reason that patients with dark skin need to be VERY careful with this procedure—the laser can accidentally target some of the skin in addition to the follicle. This can result in burns and even changes in pigmentation which can present as lightened spots.

The reason this procedure requires multiple treatments is because this specific type of damage can only be done to the follicle when it is in its growth stage of hair. Hair growth occurs in cycles so not all of the follicles will be in the proper stage.

Make sure that you keep in mind, electrolysis is the ONLY method that the FDA considers to be PERMANENT. Laser hair removal patients often find that they experience re-growth after some time, although it is usually finer hair than they originally had. And I’ll say it again, make sure you go to a reputable technician… preferably a doctor who has been doing this for a long time.

Breast Lift (Mastopexy)

Breast implants are a great idea for somebody who wants to increase their size, but what if you are happy with your breast size and just want to restore a youthful appearance by making them perkier? A mastopexy (or more commonly known as a breast lift) may be the right choice for you. This procedure can even be done in combination with implants if you are looking for an increase in size as well as better shape and placement of your breasts.

A full breast lift is where the doctor makes a cut in the crease below the breast, a cut around the areola (nipple) and then an incision from the areola to the cut in the crease—this is known as an anchor incision and as you can see below, it resembles an anchor.

Once the incisions are made, the excess tissue will be removed and the breast will be moved up; often, the areola will be reduced in size too.

This procedure will result in different scarring than a typical breast augmentation would. The scar around the areola will often not be noticeable, since it will be hidden in the color of the nipple. The scar at the bottom of the breast, located in the crease, will also be fairly hidden since the breast will often lay over that area. As a quick side note, these two incisions are also used in breast augmentation since they do not leave extremely noticeable scarring, so I wouldn’t worry too much over the marks they will leave. The last scar, and the one you do want to concern yourself with, is from the incision connecting the areolar cut to the cut in the crease. This straight line from nipple to the base of the breast will  fade over time but will probably not ever be perfect.

A modified breast lift will result in scarring that is much less noticeable—however, since this procedure uses fewer incisions (which mean less scarring) it is not able to alter the breast shape as well. For this reason, this type of procedure is often done in combination with breast implants. The popular incisons for this are either the donut lift or the crescent lift.

The donut lift (or Benelli lift) removes a ring of skin around the nipple and then sutures it back together thus removing tissue from the breast.

The crescent lift will have an incision around the top of the nipple and basically move the nipple up on the breast after removing the tissue above it, thus lifting the breast.

Here are some examples of what a breast lift can do:

Both of these women had a crescent incision breast lift as well as implants inserted. As you can see, a breast lift can make a tremendous difference.

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Liposuction

Working out can do wonders for your body. It can help you tone up and lose weight, but often you reach a point where no matter how hard you try you can’t get that last stubborn few pounds off. This is where liposuction comes in. Liposuction is the process of removing fat from your body; it can be useful in simply taking unwanted fat off, or it can be used to help sculpt and shape your body. Liposuction is ONLY the right choice for you if you are looking to get rid of a small amount of fat, and if you have already tried diet and exercise. Any larger amounts and you will want to look in to some kind of “tuck” procedure (like a tummy tuck), which I will talk about later.

This procedure is done by removing fat using a tube and suction device (called an aspirator). There are different options for how this is done regarding fluid injection and how the tube portion works. Wet liposuction uses a small amount of fluid (a smaller volume than the amount of fat you want to remove) that will contain a local anesthetic (like lidocane), a salt solution to make it match body fluid tonicity, and adrenaline which will help contract blood vessels and reduce bleeding. The fluid will help loosen the adipose (fat) cells, and to minimized bruising. The fat is then suctioned out. Super wet liposuction uses roughly the same volume of fluid as quantity of fat that you want to remove. This is popular for procedures that are removing LOTS of fat. Laser assisted liposuction utilizes thermal and laser energy and it is even thought to increase skin tightening.  The benefits of this method over traditional methods is still somewhat contested though, so if you are going this route make sure your surgeon is very experienced. Tumescent liposuction involves the injection of large volumes of a solution (which is made up of an anesthetic and vasoconstrictor) straight into the fat you want to remove. This can be a very dangerous method if you are having a large volume of fat removed.

Those all deal with the fluid portion, but the actual method of removing the fat is related to the canula that will get the fat out of the body. There is a wide variety of options for this as well: suction assisted is the industry standard—a tube is inserted that is attached to a vacuum device and as your doctor moves it around, it breaks up and suctions out the fat cells. Ultrasound assisted uses a special tool that transmits ultrasonic vibrations in the body that emulsify (liquidate) the fat which makes it easier to suction out. This process requires the use of suction assisted afterwards to remove all of the emulsified fat. Power assisted does the same thing as suction assisted but it has a mechanical device that eliminates the need for the surgeon to move it around as much since it will move on its own.

Your recovery from this will be about a week or two before you can go back to work and normal light activities. You are going to need to wear a compression garment for up to one month. Your doctor will prescribe you pain medication and you will see your final settled results by 6 months. Prior to that, there will be considerable bruising (which will subside within a few weeks) and swelling (that will go down over the first two months). Depending on where you have this done, expect to have limited motion since you will definitely be sore.

Here are some great before and after pictures so you can see just how effective this procedure is: 

These images are all excellent examples of not only how much fat can be removed, but the benefits you can have from shaping. In some cases, the doctor can even shaped the fat removal to make your muscles look more defined (I've even seen cases where patients come out looking like they have 6-pack abs).

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Lip Augmentation

Full, luscious lips are thought of as a sign of youth. If you are looking to take a few years off your appearance, perhaps some lip enhancement can help you. This is a delicate procedure because, as I have mentioned before, even small changes to your face can change your appearance a great deal. However, lip enhancement is a GREAT choice for those who are unsure of what they want. This can be a temporary or permanent procedure and thus it allows you to figure out what you want. Over time, a very large variety of substances have been used. Some work better than others, and today there are a few main fillers that you can choose from.

One important thing to know is that you should not get lip injections done within 6 months of taking the acne medication Accutane. You should also not get the injections if you plan on starting to take Accutane within 6 months. This medication has been shown to increase certain scarring, and you definitely do not want that! Also, discuss any active diseases that you have (like diabetes) because these can affect how your injections come out.

Lip augmentation can be surgical (using implants) or nonsurgical (using injections).

Lip implants can include: dermis grafts (skin grafts), fascia grafts (fascia is a type of connective tissue in the body), tendon grafts, AlloDerm, and Gore-Tex.

                Alloderm is a dermis graft that comes from human cadavers—it does not last very long, and is fairly expensive so I would advise you to look at the other options before deciding on this one.

                Gore-Tex implants are nice because they are permanent but they are reversible. So if something goes wrong, you are able to fix it. They are made from expanded polytetrafluoroethylene, aka ePTFE. This material is not toxic and will support tissue incorporation so it will definitely seem natural.

The incisions for this surgery are made right on the corners of your lips. Lips are highly vascular and have a fantastic blood supply so they will heal very quickly! This image shows you where the cuts are made:

Lip injections include: human/porcine/bovine collagen, and restylane.

                Most of the available injections are TEMPORARY. Collagen will last for about 3 or 4 months. Before you get collagen injections, make sure that you have a skin allergy test! Permanent injectable materials are rare, but you can  look in to Artecoll or Aquamid for example.

Restylane is a very popular choice today; it is used for lip injections as well as for filling in fine lines on the face. The recovery time is VERY fast (about 2 days) and you will need to have injections done again about every 6 months.

Here is a very nice example of a lip augmentation. You want to make sure to be modest with the size increase and to keep the lips proportional, otherwise you risk looking unnatural and duck-like, or worse.

People chose either injections or implants for a variety of reasons. Injections are known to give lips a more pouty appearance than implants do, so if that is what you are looking for injections might be the better choice for you. Another major thing to think about is how long you want this to last. If you are just flirting with the idea of having fuller lips, be sure to go with something that will wear off in a few months.

It is extremely important to find somebody with LOTS of experience doing this procedure, especially if you are having something permanent done. Everybody has seen what a bad lip augmentation looks like, and if you haven’t take a look at Lisa Rinna’s lips—she was pretty much the poster girl for lip augmentation gone wrong.

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Butt Augmentation

If your back-side just isn’t cutting it for you, maybe you’ve been thinking of a buttock augmentation. There are two types, the butt lift or implants.

The butt lift, often called the Brazilian butt lift, involves a combination of removing fat from certain areas around the butt and adding fat to certain areas. Often the fat that is injected back into the patient comes from the fat removed from the butt and other areas like the stomach or any other problem areas on the patient. The fat will be processed before it is re-injected. This process is like sculpting the patient’s buttocks—the doctor removes stuff from areas that it should be, while adding to areas that need more volume. Below are some examples of before and after for a Brazilian butt lift. As you can see, this procedure is great for giving the buttocks a younger, perkier appearance.

The other option is to have implants placed in. These implants are not like breast implants—they are made of a VERY strong material, which is what you would expect because they will have a great deal more force placed on them on a regular basis compared to breast implants. A small incision is made and the implant is inserted right above the muscle and underneath the layers of connective tissue material (called fascia). The scarring that results from this procedure is negligible and most often is not visible in the long term.

The recovery from this surgery is pretty serious, you are not supposed to sit on your butt directly for up to three weeks. This means that if you have a job or pretty much any other obligations, you’re going to need to make other arrangements. You may be a bit surprised when you hear the cost for a Brazilian butt lift, but make sure you keep in mind that not only are you getting a butt lift, you are also going to be getting liposuction. Below is an example of a patient who received butt implants.

This is one surgery where it is absolutely IMPERITIVE for you to pick the right doctor. These are delicate surgeries. I’m sure you’ve seen at least one news article about somebody who flew to South America to have a Brazilian butt lift performed and then died later from complications. Make sure your surgeon knows what he is doing! The process of purifying the fat after its removal from your body and before it is injected back into your butt is especially important, so make sure you speak with your doctor about how he does that.

Overall, deciding which of these methods is right for you is a tricky choice. Speak with a doctor who is well-practiced in both types of surgery and explain to him the results you desire. If you want to shape up that entire region, you will likely want to go with the butt lift; if you are just looking to add a bit more volume then perhaps implants are the better choice for you. One bonus for butt implants is that, many patients say, if you lose weight after the surgery it will not come off of your new butt. Either way, do your homework and find a reputable surgeon. Then, enjoy your new curves!

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Laser Hair Removal

Laser hair removal is all over the place right now. There are ads for it pretty much everywhere you look. It seems like an amazing procedure—painfree and permanent hair removal, who wouldn’t want to do it? However, it is not right for everybody. This procedure works best on those with light skin and dark hair. There are a variety of lasers on the market today and they are beginning to adapt to work on a wide range of skin and hair color combinations. These newer lasers are more effective at removing dark hair from patients with dark skin, so those of you with light hair will need to wait a bit longer (and keep your fingers crossed that they continue to make advancements in this field).

To start off with, laser hair removal works by targeting the melanin in your hair. Melanin in the hair follicle comes from melanocytes that are located in the lower layers of your skin. They produce melanin (a pigment) which then enters the growing hair. This is the same compound that gives people different skin colors. Minor genetic differences determine the location of the cells which is what makes hair (or skin) darker—if the melanocytes are located closer to the skin surface there is less time for the melanin to degrade and therefore the hair and skin will appear darker. The laser will target the hair follicle and destroy it which means it will no longer produce hair.

There are some choices to be made, and you will want to speak with several laser centers to find the best one for your hair/skin combo. An Alexandrite laser is often the laser of choice for those with pale skin—make sure that this is not the laser used if you have dark skin, it is NOT safe for dark-skinned patients! Patients with dark skin need a Nd:YAG laser (a neodymium-doped yttrium aluminium garnet laser) which is also effective on lighter tones. As a side note, the Nd:YAG laser is not only used for hair removal, but it can be effective in treating vascular problems like spider veins. The other option is a pulsed diode array laser which is best for pale or medium tones.

It may be scary to think that a laser will be used, but this procedure is painless. The laser will get warm, but they are always combined with a cooling system to prevent pain. This can be contact cooling (which is inside of the laser unit and will be touching your skin so it can keep the unit cool), air cooling (fored cold air that works in a similar manner), or a cryogen spray that is placed directly onto your skin.

Keep in mind that this is NOT a one-time thing. You will need multiple sessions; most people require 6-8 sessions for maximal results. With this being said, you will see immediate results after the first session. Your hair grows in cycles, not all of the follicles are active at the same time, so one treatment will kill all of the actively growing follicles but it will not get the ones that are inactive. This is why multiple treatments are necessary.

As with any procedure, it is important to find a skilled doctor to perform this. You may want to save money by finding the cheapest place possible, but make sure that they know what they are doing. The side effects if something goes wrong can be pretty rough and scarring is common among procedures that were done by inexperienced people.

The above image is to give you an idea of what a bad reaction can look like. Always make sure that the laser being used is the right type and at the right setting for your skin tone. Also, it is smart to have them do a test spot before treating your whole body.