Botox, Browlift, Blepharoplasty: How Do I Choose?

How do I tell which procedure or combination will give me an improved appearance around my eyes? Well, during an in-person consultation, we would demonstrate on your face and help you decide, but here are some hints:

1. Frown lines and squint lines or crow's feet respond to Botox treatments. A browlift may give longer lasting improvement in frown lines, but more motion will usually remain. Only the Botox will reliably improve the squint lines.

2. Excessive active lines crossing the forehead do not go away with typical browlift. Instead the entire forehead unit moves up a little (gravity has pulled it down). Botox can diminish the lines, or make them go away if they're mild.

3. Be careful about using Botox for too much forehead treatment. You may have either no natural forehead expressions (people wonder about you) or you may have drooping brows (we use our forehead muscles to lift our brows).

4. If your eyebrows are slightly too low, a little Botox beneath the inner and outer corners can give a little lift, without surgery.

5. If your eyebrows and thick skin just under the brows closes-in around your eyes, that responds best to surgical browlift. In addition, that procedure may improve your upper eyelid appearance.

6. Hooding of the eyelid skin over the lid or lashes improves with blepharoplasty (eyelid lift, tuck)

7. Puffy, thick upper eyelid folds respond to blepharoplasty.

8. Finally, a laser peel can greatly improve the texture of the eyelid skin. Sometimes that would be enough, without skin removal.

Obviously, some or all of these techniques may work together to enhance your appearance.

"Water Bottle Lips" Instead of "Smokers Lines"

Friends tell me that the national news ran an amusing item. It seems someone has decided that sucking from the spout of sports water bottles on a regular basis may cause wrinkles in the skin around the lips. Hydration is good for the skin, so don't stop drinking plenty of water.

Smoking was a problem in two ways. It seemed to accelerate skin aging chemically and smokers pursed their lips while sucking in the smoke.

If excessive lines develop, we offer a variety of solutions:

• Obagi skin care
• Fillers such as Restylane or Juvaderm
• Skin Tightening, minimally invasive
• Laser Peels

Sagging versus Wrinkles

I recently heard a great analogy comparing facial skin to fabric. If the surface isn't smooth you need to iron it (surface treatments such as Obagi skin care or laser peels). If the fabric hangs too much you need to take away the slack (necklift, facelift, browlift, etc.).

I'm sure many readers can relate!

Beauty for Life Update

In my first post, I said everyone should be aware of this concept: appropriate procedures (minimally-invasive and surgical) are available at different stages of life. Our national societies have published a new website www.beautyforlife.com.

It starts with good skin care in your teens. Botox may help maintain softer expression lines. Breast lift & tummy liposuction or tuck are known as the mommy make-over, after having children. Eyelid lifts and facelifts compliment the later changes in our faces. If you're interested, look at our practice website and the beauty for life site.

Cosmetic Procedures Increase 7%

Here are the highlights from 2007 from ASPS:

Facelifts up 14 %
Breast Implants up 6%
Slight increase for eyelid surgery
Injectables increase
Ethnic patients up 13%
Mild inc. in breast reduction & reconstruction
Liposuction steady
Decreases in rhinoplasty
Steep drops in collagen and hair transplants

The biggest news was that facelifts, that had decreased in the last few years, now returned as more commonly requested by patients. This may be due to realization of the limits of Botox and Hyaluronic acid fillers (Restylane, etc.). They don't correct laxity, sagging, drooping skin & deeper layers.

Breast augmentation remains the most popular procedure, and its popularity increased. It remains popular in 2008 at our office.

The TOP FIVE surgery procedures were: Augmentation, Liposuction, Rhinoplasty, Eyelid, and Tummy tuck. The TOP FIVE non-surgical procedures were: Botox, Hyaluronic fillers, Peels, Laser hair removal, and Microdermabrasion.

We thought you would like to know!

Breast Augmentation in South Carolina

Everyone looks forward to Spring and Summer. Some of the best things about those seasons are shedding winter clothes and enjoying the out-of-doors. In South Carolina we have great weather, beautiful beaches, extensive lakes, mountain trails, roadways for motorcycling and bicycling, golf courses, tennis courts and plenty of swimming pools.

Perhaps that's why breast implant / augmentation is our most popular body contour procedure. We perform this more frequently than tummy tuck (also common) or liposuction (most common in national surveys). Contact us and you'll find many other ways in which we are different form other medical practices you've encountered.

Patients seek breast surgery during the Spring & Summer to enhance their looks. Its a very popular time of year.

You can find more details on our website, http://www.expertplasticsurgeon.com/ or our link http://www.breastaugmentationcarolina.com/.

Office Plastic Surgery & Anesthesia Safety

The safety of both anesthesia care and surgical procedures has improved greatly in the past 25 years. The number and complexity of out-patient surgery across all surgical specialties has increased several fold. All surgery involves risks, but risk reduction is accomplished in many ways.

In 2007, according to the American Society of Aesthetic Plastic Surgeons, 54% of all cosmetic procedures were performed in office surgical centers, and another 28% in out-patient surgical centers. That leaves only 17% having been done in hospitals. Surgical procedure statistics showed 8% increase from the prior year. (http://www.surgery.org/)

National accreditation is one important assessment of the dedication and quality of a office surgical facility. The American Association for Accreditation of Ambulatory Surgical Facilities evaluates our facility(http://www.aaasf.org/). We undergo annual assessment requiring 100% compliance, including periodic inspection. The criteria are numerous, but include preoperative medical screening, availability of emergency equipment and medications, and advanced life support certification. These address some of the questions raised by recent media & public concern over safety issues in Florida, California, and NYC.

We offer full-time board-certified physician anesthesiologist care, in addition to our board-certified plastic surgeon. All our anesthesia is personally done by the anesthesia doctor. Dr. Graham concentrates on your surgery and is not responsible for also supervising a nurse anesthetist. Safety is an attribute of our practice. For other ways in which our practice is different, read our new website.

Update July 16, 2008. See the link http://www.plasticsurgery.org/media/press_releases/July08-PRS-PatientSafety.cfm