Jessica,
It is not unusual as women get into the middle to late 40’s for age related changes to catch up with them and begin manifesting. Of course a healthy diet and hydration are always important to the body and in turn the facial appearance. Additionally, as menopause occurs or approaches changes in hormone levels can affect skin quality and tone leading to a more rapid progression of aging. All of these things are big topics and are better addressed in person. However, we tend to look at facial aging with three main points in mind: 1) skin quality 2) gravitational effects 3) volume loss. Skin quality can be improved through sun protection, the use of good skin care products like PCA, and the addition of therapies such as Botox, Restylane, Juvederm and Fraxel laser. All of these are listed on this site with more information. The second element, gravitational effects on the face, need to be corrected through the use of surgical procedures. At 46, we usually try to limit the procedures to minimally invasive office procedures that have a quick recovery time. The third element is volume loss. This can be addressed through the use of facial fillers such as Restylane, Perlane, Radiesse and Juvederm or through the use of autologous fat. As you can see there is much that can be done to reverse the signs of aging. We would love to be able to have the opportunity to tailor a personalized plan for you. Please spend some time educating yourself on our site and please plan to come in and have a personal conversation.
Ed Buckingham
Lisa,
Yes we do perform asian or double eyelid surgery. The procedure is usually performed in the office under local anesthesia with some oral medications to relax the patient. Some patients prefer to have a deeper level of anesthesia at our surgery center, which can be arranged. 18 is certainly old enough to have the procedure. There is a limit as to how young someone can be, but it is variable based upon individual maturity levels. We would be happy to see you in consultation and discuss this further.
Ed Buckingham
Mike,
Thanks for your question regarding chin augmentation material. We use a company called Impantech for our implants. We usually us silicone implants. Silicone is a polymer of siloxane. It can be made into a liquid, gel, semi-solid or solid depending on how many molecules you link together. In the case of chin implants it is a flexible solid, ie bendable but maintains its shape. We also will us autologous fat to augment the chin in certain circumstances. I hope you find this information helpful. Please feel free to contact us with any further questions.
Ed Buckingham
Joanna,
Thanks for your question comparing Fraxel re:store and Fraxel re:pair. Fraxel in general is a fractionated laser. This means that instead of the laser removing the outer sun damaged skin in its entirety, it only removes a portion of the skin in a microscopic dottted type fashion. This improves the skin considerably, but allows healing to take place from the undamaged skin islands as well as from below. Therefore the healing is much faster and the procedure is safer than fully ablative lasers.
The Fraxel re:store is an erbium laser vs. the Fraxel re:pair which is a carbon dioxide laser, or CO2. The difference for the patient is that the Fraxel re:store leaves not only some islands of skin intact, but also leaves the outer barrier intact so that you can leave the office with sunscreen on and makeup if you desire. There is swelling for about 2 days and redness for about 5. The Fraxel re:store is a series of 4-6 treatments at approximately 1 month intervals. The Fraxel re:pair does not leave the outer barrier intact and so the patient has a little longer recovery and needs to wear ointment on the face for about 8 days and can not wear make-up. The treatment is performed in a single session however. Both lasers will improve skin pigmentation, texture and lines.
I would recommend coming in for a consultation to determine which procedure would work best for you.
Ed Buckingham
Jolie,
You can achieve natural results with either an endonasal or an open approach to rhinoplasty. The different approaches both work, but each should be used in the appropriate circumstances for that patient and according to the surgeon’s preference. There are surgeons who perform almost all of their procedures one way or the other. I prefer to use the endonasal approach in simple noses that require only a hump reduction with perhaps a little tip narrowing and in a nose that could also be made a little smaller, deprojected, and/or rotated a little. If a nose has significant asymmetry, needs more tip work, or needs to be projected or de-rotated then I prefer the open approach. I am also very careful to not over narrow the middle part of the nose which can happen in an endonasal rhinoplasty. If my patients have any narrowness to their nose pre-operatively and need a hump taken down, the narrowness will likely get worse and so I place what is known as spreader grafts. This will not only lead to a more natural result, but will also prevent functional and cosmetic problems years down the road.
Sorry for the long answer, but rhinoplasty is a very complicated operation and requires a little more thought than just a yes or no answer. Good luck with your decision.
Ed Buckingham
