Question: I had been having chin augmentation with Radiesse. I absolutely love the shape but I am looking for something more permanent. Is it possible for surgeons to copy the shape of the Radiesse injection with an implant?
Answer: I do not know that it is possible to precisely copy the shape of a Radiesse injection with an implant but certainly we can evaluate your chin shape and decide what type of implant would give you the best results. There are other modifications to chin implant surgery that can be performed to the underlying muscle so that we can improve the appearance of a cleft or even theoretically create a cleft if one would be desired in the midportion of the chin.
Question: At 52 years old, I am a very physically fit male and take pride in my appearance. I am starting to get the telltale signs of jowls and a little double chin. No matter what I do I cannot get rid of them. Would facial liposuction be an appropriate procedure for me or do I need to have a facelift along with it?
Answer: More than likely at 52 years old liposuction is not the best procedure for you. As we get a bit older and our skin loses its elasticity it simply does not bounce back and we therefore end up with some laxity. Liposuction alone will only reduce some of the volume, but will not improve upon laxity and can actually sometimes make laxity look worse. More than likely what you would need is at the very least a necklift, but you may want to consider a full facelift as well depending on your particular anatomy. A necklift or mini-lift can be performed in the office setting using strictly local anesthetic or as more sophisticated facelift techniques, such as what I perform in the operating room which is called and extended SMAS or high SMAS deep plane facelift can provide much more rejuvenation and longevity, but does require going to the operating room. Ultimately, I recommend a consultation so that we can discuss your desires and then I will discuss the specific details regarding each possible treatment so that a customized treatment plan can be created just for you.
No, I would highly recommend that you not let anyone place ArteFill in an empty pocket where a chin implant was removed. ArteFill is a methylmethacrylate permanent injectable filler that is designed to be placed in the dermis of the skin and placing large quantities of this substance in a pocket in the chin I think would have a very high risk of some sort of complication. Mainly, I would be concerned that the filler material would not provide adequate support for the chin and you could end up with asymmetries, bumps, nodules, and even infection. Depending on the reason that you required a chin implant removal, I would personally recommend replacement of the chin implant with another more appropriately sized implant. This could be performed at the same setting as the removal of the implant if the only reason for removal was due to malposition, malplacement, or an overly large or small size. If the reason for removal was infection, then you may have to wait until the infection completely subsides before another chin implant can be placed. I would again caution you against placement of any sort of filler in the chin area as I personally feel that you would have a much higher likelihood of a successful result if you opt for revision chin implant surgery.
Yes, there are certainly options for patients that are not healthy enough to undergo general anesthesia specifically regarding their lower face. Standard facelifts or certainly extended SMAS deep place facelifts are typically performed in the operating room setting under either deep sedation or general anesthesia. Options for patients that are not healthy enough to undergo these types of anesthetic care would be mini facelifts, which can be performed under local anesthesia in the office and I have certainly performed these on patients that are not qualified for procedures performed in an operating room setting. Though this treatment is compromised compared to the more sophisticated and technically demanding extended SMAS deep plane facelift, they nonetheless get a very significant improvement in the lower third of their face and these patients are quite satisfied with the results of this type of surgery. A more advanced and newer technology that is available now for patient that are showing the early signs of aging would be Ultherapy, which is an ultrasound device that can target the deeper layers of the skin and this ultrasound energy is then focused on the deeper layers thus heating up the collagen and causing new collagen deposition, which in turn results in tightening of the deeper tissue and lifting of the facial structures. This can be performed in the area around the eyes to cause a nonsurgical brow lift. This can also be used to treat the midface, jowl, and the area under the chin to create the lift of a miniature facelift. There is no need for any anesthetic and there is absolutely no downtime as this is performed in a medical spa setting and the patient’s own healing creates the lift over a three-month period. This would be an excellent alternative for any patient with early aging that is not a good candidate for a standard facelift.
Yes, a mini facelift at age 41 would be perfectly appropriate assuming that you have the early signs of aging including early jowling and early submental laxity, which is excess skin under the chin. I have performed many minilifts in patients under the age of 40 simply due to the fact that they have early signs of aging including these early jowls and the laxity under the chin and this procedure is excellent in patients in that age group. In fact, patients with early signs of aging are really the best candidates for treatment with a mini facelift as this procedure really does an excellent job in rejuvenating the lower third of the face and I personally feel that the patients in an older age group or with more significant signs of aging are best treated with a more sophisticated extended SMAS deep place facelift, which will restore not only the jowling and laxity under the chin, but also lift the midface and improve the smile lines as well. The bottom line is that I recommend that patients undergo rejuvenation at the earliest signs of facial aging mainly due to the fact that the rejuvenation is more effective, it involves less downtime and less risk, and overall they will have a longer period of time where they can enjoy their rejuvenated appearance.
Ultherapy is a revolutionary treatment for the early signs of facial aging, such as low set brows, early jowling, and skin laxity under the chin. It uses ultrasound to visualize the tissue underneath the skin, then sends a focused wave of ultrasound energy that is targeted at the deeper tissues. This causes denaturization of the collagen, and the healing process then creates new collagen that tightens and lifts the soft tissue. The brows are lifted, and the jowls and laxity improved. The result is a more refreshed rejuvenated appearance. The procedure is performed in Quintessa Medical Spa, takes less than an hour, and has absolutely no downtime. Over the next 3 months, you should slowly see the improvement in your appearance. Right now, we have special pricing for Ultherapy saving you thousands. The area around the eyes including the eyebrow lift is $1500.00 (regularly $1800.00). The lower face is $2200.00 (regularly $2900.00), and both the upper and lower face together is $2900.00 (regularly $4700.00) Ultherapy seems to work best in patients that are 40-60 years old with early signs of aging, so you may be an excellent candidate.
I recommend you contact us for a complimentary consultation so we can evaluate your facial anatomy to make sure Ultherapy is right for you.
The answer to that question really depends on the patient’s age. If the patient is relatively young and has very elastic skin, there are various nonsurgical treatment options available, but the most productive and most efficacious treatment would involve some sort of fat removal. Classically this is done via liposuction through an extremely small excision below the chin. This can easily be performed in the spa setting and we frequently perform these at Quintessa Medical Spa using just local anesthetic. There is very little downtime as I just place a pressure dressing overnight and this can be removed the following day. I recommend the patient wear an elastic sling in this area as much as possible for the first week and then they can essentially resume normal activities. Most patients do not have any visible bruising from this procedure and therefore, downtime is very minimal. There are newer lasers available that can not only liquify fat, but help to tighten the overlying skin. I have not found these to be horribly helpful in this area of the face and therefore I continue to perform relatively classic liposuction in this area as we get fantastic results with extremely low risk and I have not found that the lasers are helpful. Other nonsurgical options for a double chin are going to be less effective, but there are various ways to tighten the skin in this area.
The most efficacious treatment available at this point in time appears to be Ultherapy, which is an ultrasound based technology that can heat the deeper tissue using ultrasound waves.
This technology is very exciting due to the fact that it completely bypasses the overlying skin and thus creates no injury whatsoever to the skin, but only injures the deeper tissue and then collagen growth causes tightening of the area and visible results can be seen within approximately three months.
We are excited to have an Ultherapy device at Quintessa Medical Spa as we wereone of the first ten facilities to obtain this device in the United States and will be one of twenty-five facilities in their phase one clinical release.
I would recommend contacting us for a consultation if you are interested in discussing Ultherapy or the minimally invasive liposuction.