Dr. Buckingham’s Q&A

Question:
What are chin implants made from?

Answer:
Chin implants can be made from a variety of materials including Medpore, Silicon and Gortex.  Most commonly they are made from silicone and that is the variety we use.  The second most common material is also silicone that has been coated with Gortex.  We don’t find this to be advantageous for the chin, but it may be of assistance with the cheek as it allows a small degree of tissue in-growth to secure the implant that is not necessary in the chin area. 

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Question:
I’m interested in a facelift, though my main concern is the neck area. What is the difference between removing just fat from the neck area with liposuction and tightening the muscles there? Is one approach better than the other?

Answer:
Liposuction of the neck is useful for patients who are young and have good skin tone with excess submental fat as the primary cause of their neck contour concerns.  I often however even in young patients will tighten the muscle to improve their results, a platysmaplasty.  A facelift involves making incisions around the ear to tighten the muscles from that aspect.  It is useful for improving the jowls, therefore restoring the jawline.  It is often combined with neck liposuction and platysmaplasty to maximize the result.  It is necessary in the patient who is older and has lost the elasticity of the neck skin to improve this area. 

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Question:
I have very bad facial acne scars. I hate looking like this and it seems to look even worse every year. I am Mexican and have darker skin. Is there a skin resurfacing procedure that I can have that won’t change my skin color but will get rid of some of the pitting on my face?

Answer:
Because of your darker skin type the procedure chosen will have to be less aggressive than someone with lighter skin types.  Additionally, we will need to pre-treat your skin with a topical agent to reduce the risk of tanning in the area of treatment.  With that said, a variety of fractionated lasers can be used to improve your scarring.  A detailed consultation will compare these treatment options. 

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Question:
What is the difference between dermabrasion and microdermabrasion?

Answer:
Dermabrasion is a surgical procedure using a variety of different sanding devices to remove the outer layers of the skin.  The depth of dermabrasion is into the dermis therefore requiring a period of recovery using facial ointment.  The results from this treatment can be dramatic however.  Microdermabrasion is performed by an aesthetician and only removes the dead layer superficial to the epidermis.  It is useful to brighten the skin, but it will not improve wrinkles, pigmentation or scars. 

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Question:
Over the years, the skin on my face seems to have become several different shades. I am interested in a chemical peel to even out the skin tones on my face. Can I get a chemical peel for this that will also remove some of the finer wrinkles?

Answer:
A chemical peel is great option for removing facial pigmentation alterations associated with time and sun damage.  A Jessner’s/35% TCA peel is usually the type we will use for this.  The procedure is performed under light sedation and requires about 10 days of ointment and 14 days without makeup.  Another great option for this is a fractionated CO2 laser.  This procedure is again performed under light sedation.  The procedure can be adjusted to different settings however to balance the patient desire for improvement with the amount of recovery time allowed.  If the patient cannot tolerate down-time then lighter peels may be used.  Regardless of the method of resurfacing, good skin care with sun protection is a must to maintain and maximize the result. 

Posted by Dr. Buckingham