Dr. Buckingham’s Q&A

Question:
Is there a risk for hearing loss in a patient who has otoplasty?

Answer:
No aspect of the hearing apparatus is affected during otoplasty.  It would be highly unlikely for any injury to occur to the ear canal or deeper structures which would lead to hearing loss.

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Question:
Is IPL a good treatment for aging skin? I’m in my early 40s with some minor wrinkles and sagging and texture irregularities.

Answer:
IPL is a good treatment for skin pigmentation and vascularity. It may provide some dermal thickening but is not a treatment for sagging, textural irregularities or wrinkles. Another laser treatment such as fractionated carbon dioxide laser was reviewed and is laser a better for fine lines and wrinkles.  Sagging tissues may be better treated with volume augmentation using fillers such as Restylane and Juvederm or possibly the patient’s own fat. More significant sagging is better addressed with surgical intervention for instance limited incision facelift.

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Question:
If I look up close at my face in the magnification mirror, I see fine wrinkles almost all over my face. Are these tiny wrinkles the type of wrinkles that laser resurfacing erases?

Answer:
In general, I would recommend not utilizing a magnification mirror to analyze your face.  A better option would be to analyze the face in the mirror from 2-3 feet.  This will give you a better impression of the true aging characteristics of your skin.  Wrinkles which are visible in this manner can be easily treated with laser resurfacing techniques. There is a host of available treatments in fact to help fine lines and wrinkles and only a consultation will determine which procedure is most beneficial for an individual patient.

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Question:

What filler is good for improving the area under the eyes or the tear troughs?

Answer:

Different fillers can be used under the eyes and in the tear trough areas.  These would include Restylane, Juvederm, Radiesse and even Sculptra.  Sculptra however should be used with significant caution in the thin skin around the eyes. Additionally, Radiesse can be massaged into the tear trough area, but direct injection may cause visible lumpiness. Both Juvederm and Restylane are great alternatives for the lower eyelid however Juvederm attracts greater quantities of water and so therefore may cause puffiness in a greater percentage of individuals. We prefer to use Restylane in the lower eyelids as we feel that it provides the softest results without the disadvantages Juvederm presents. For the same reasons we prefer Juvederm as the hyaluronic acid in the perioral area. The other advantage of hyaluronic acid is that they may be reversed by an injection of an enzyme.  This adds an additional level of safety for their use of the periocular area.

Posted by Dr. Buckingham

Question:
What should I look for when looking at before and after pictures of a potential surgeon to perform my facelift?

Answer:
One advantage of the internet is that it allows the patient to examine the physicians before and after results.  What appears to be a good result to one patient may not appear to be that way to another.  In our practice, we strive to provide significant benefit for the patient from the preoperative to the postoperative photograph, while creating a natural result that cannot be detected as cosmetic surgical intervention by looking at the postoperative photo alone.  We do not want anyone to look at our patient postoperatively and know that they have had cosmetic surgery.  If you compare their postoperative result to their preoperative photo however, there should be a significant difference.  Patients who are looking for these types of results will be attracted to our website and facility.  A patient looking for a surgical result that appears more "operated", may seek a surgeon who has before and after photos demonstrating that type of result.

Posted by Dr. Buckingham