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Category : Cosmetic Surgery

JUVÉDERM VOLBELLA® XC, The Newest Lip And Under Eye Filler

juvederm volbella the newest lip and under eye filler

JUVÉDERM VOLBELLA® XC is the very newest member of the Juvederm family of facial fillers, and can be used to perfect your pout and help erase under eye circles for longer than previously-used fillers. It is a smooth gel formulation made up of a modified form of Hyaluronic Acid, a naturally-occurring sugar found in the human body. The role of Hyaluronic Acid in the skin is to deliver nutrients and help the skin retain its natural moisture and softness. The JUVÉDERM VOLBELLA® XC gel formulation also contains a small quantity of local anesthetic (lidocaine) that helps minimize discomfort during injection.

How Long Does It Last?

JUVÉDERM VOLBELLA® XC is exciting because it is longer-lasting than other similar fillers previously available such as BELOTERO BALANCE. It lasts for up to a year in the lips (compared with around 5-6 months with previously available fillers) and up to 2 years under the eye (compared with around 1 year for previously available under eye fillers). The longer duration is due to the patented VYCROSS® technology that blends different molecular weights of hyaluronic acid.

JUVÉDERM VOLBELLA® XC For Lips

The decision to augment the lips is usually one that is easily made by my patients. Either they want fuller lips, or poutier lips, or they don’t. It’s more difficult for people to determine on their own if their dark circles would benefit from JUVÉDERM VOLBELLA® XC injection.

JUVÉDERM VOLBELLA® XC For The Under Eye Area

When it comes to filling under the eyes, the best candidate for injection is someone who’s under eye darkness is the result of “hills and valleys” under the eye. The “valleys” are hollow, sunken spots that, when they’re beside normal, plump areas (“hills”), create shadowing—and the perception of dark circles. To help determine if your circles are shadow-related, sit down in a room with overhead lighting. Take a mirror and first look straight into it while seated and holding the mirror at eye level. Say hello to your circles. Next, lay back a bit, and let the overhead light hit you directly on the face while looking into the mirror, so that all under eye shadows are eliminated. If the darkness under your eyes disappears, it’s shadowing that’s causing the circles, and JUVÉDERM VOLBELLA® XC may be a good option for you. If the darkness remains, the problem is probably excess pigmentation in the skin, something filler will not address.

So, say goodbye to your under eye circles with your newly-plumped pout just in time for New years! Yes, please!

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Tales Of Anti-aging Eye Treatments And Creams

tales of anti-aging eye treatments and cream

The area underneath my eyes had been bothering me for a while as with the march of time, it was starting to look a bit hollow. I had done some research and knew that injecting fillers in the tear troughs could improve the look of the area, but for me, putting a syringe close to my eyes was a scary proposition! Still, I had seen good results with fillers on a friend or two and was considering the option. Then, I looked into laser treatments and in the process learned that they could also brighten the under-eye area in more ways than one.

Veins Glorious Veins!

While I was contemplating the idea of fillers, I went to see Dr. Roy Geronemus to eliminate some broken capillaries on my cheeks. He pointed out the visible blue veins underneath my eyes and said that he could remove those with a laser too. Ditto for the larger veins around my temples. I had noticed those blood vessels but they never bothered me much as I thought they were pretty common. Well, of course, after they were brought to my attention, that’s all I could see when I looked into the mirror. But still, I held off. Would removing these veins affect the blood flow to the eyes? Even though Dr. Geronemus and two other dermatologists assured me it would have no detrimental effect on circulation, it took me a few months to screw up the courage to submit to a laser.

The Treatment Was Not Entirely Painless, But It Was Quick

A pair of metal ocular shields were placed directly on my eyeballs to shield them from the Excel V laser. This was not something I expected and after they were plucked off at the end of the procedure, my eyes felt raw and sensitive. If you wear contact lenses, I highly recommend that you leave them at home and just wear your glasses for this treatment. As for pain, underneath my eyes, there was just a stinging sensation at the point of contact with the laser.

The elimination of the larger veins on my temples was more painful however. No topical anesthetic was applied as this constricts the vessels, making it more difficult to treat. All in all, the procedure lasted a brief 10 to 15 minutes. Costs range between $450 – $750 depending on the extent of the treatment. Afterwards, the under-eye area was a bit red and swollen for a couple of days, as expected. A small scab had formed which worried me somewhat as Dr. Geronemus cautioned that there is a very small risk of scarring. But, this too went away without a trace in a few days, helped by the application of Aquaphor. The blue veins had disappeared almost immediately and I was pleased with the fast results. A follow up visit may be necessary depending on the number and size of veins.

A Return Visit to Dr. Geronemus

In my case, a couple of visible blood vessels remained so a month later, I returned for a second visit. An unexpected and very pleasing side effect was that, by the time of my second treatment, the skin underneath my eyes looked smoother, thicker and thus lighter. Dr. Geronemus confirmed that this is not an uncommon side effect because when thermal energy is delivered into the dermis, as it is with lasers, you get neocollagenesis or the formation of new collagen. Should new veins pop up underneath my eyes, I will certainly have them treated with a laser if only for the collagen-boosting results!

Next Up Were Fillers

I had decided to take the plunge, pleased as I was with the results of the laser treatment. The fillers typically used in the under-eye area are hyaluronic acids such as Restylane, Juvederm and Belotero.

Made of a natural sugar that’s in your skin, hyaluronic acids give a soft correction to facial hollows.

Effects last approximately six months after the first treatment, but can last even longer after subsequent treatments. I opted for Belotero as the skin under the eyes is thin and Belotero is the thinnest of the hyaluronic fillers. Costs range between $700 – $850 depending on the product used.

The hollow grooves located on top of the orbital bone are referred to as the tear troughs because tears roll down this track. Although there are no dermal fillers that are FDA-approved for the tear trough, fillers are used off-label in this area.

Injecting The Eye Area Is Not Without Risks

Too much filler results in lumpiness. And if the filler blocks a retinal artery, it can cause blindness. Dr. David Orentreich is the experienced dermatologist I turned to for this procedure. After the area was numbed with a topical analgesic cream containing Lidocaine, he injected a small amount of Belotero in the tear trough, patting it down as he went along. I had a bit of swelling and redness (but no bruising) afterwards which lasted for a day or two. A week later, Dr. Orentreich manually smoothed out some residual unevenness. Injecting the under-eye area with filler has not only reduced the hollowness, but it has also plumped up some of the wrinkles, reducing the existing crepiness.

Anti-aging-eye-creamsThe Results

As a result of the laser treatments and fillers, the skin underneath my eyes looks lighter, brighter and smoother and I will not hesitate to repeat these procedures as the need arises. Not ready or willing to take lasers or needles to your under-eye area? The beauty experts at NYSD Beauty recommend these anti-aging eye creams and mask:

Lavido Alert Eye Cream is an all-natural under-eye cream from Israel that combines plant-based hyaluronic acid, cold pressed avocado oil, organic pomegranate seed oil and citrus extracts with the volcanic thermal springs from the sea of Galilee to brighten and moisturize the skin around the eye area. Clinically proven to increase skin’s elasticity and help diminish the appearance of fine lines and wrinkles.

If you need a real jolt, try Institut Esthederm Lift & Repair Eye Contour Lift Patches. These five-minute wonders contain caffeine and tighten and lift the skin under the eye area as well as smooth fine lines and wrinkles. This is Travel Beauty’s founder, Alyssa Weiss’, favorite eye product. She says your face will immediately brighten up and look younger. She loves the patches for travel, before important meetings and prior to attending gala events. To be used 3 x per week.

The light formula of Sapelo Restoring Eye Cream absorbs right into the skin, boosting collagen production with a blend of powerful peptides, reducing dark circles with botanical burdock and strengthening capillaries with a cocktail of antioxidants.

Expert Tip: Alyssa advises that “when it comes to eye creams, don’t be afraid to get in there and massage the cream into the under-eye area. Also remember to sweep up and around to the crow’s feet area — and get in there too!”

By: Delia von Neuschatz for New York Social Diary.

For more beauty tips and information, follow Delia on Instagram: @chasingbeautywithdvn

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Protox: Botox Designed With Your Professional Goals In Mind

customizable botox dara liotta

Gone (mostly) are the days of the post-injection frozen face, the seemingly emotionless Botox-bot shopping its way down Madison Avenue. As highly trained plastic surgeons in Manhattan’s upper east side beauty mecca, our needlework is getting much more subtle, “smarter”, and more customizable! Over the past year, I have seen a huge increase in younger patients, hoping to incorporate a little Botox into their regular beauty regimen to help prevent the development of fine lines and wrinkles, and to set the stage for lovely, natural, beautiful wizening (I don’t like to say “aging”). My patients, both men and women, want to look natural, just a little more refreshed and less stressed. They want to be able to express themselves with their faces- to laugh, get mad and even cry.

Introducing Protox

Often, as part of their jobs, they must be able to express themselves with their faces to be effective and successful. Lucky for us all, with some experience and knowledge, Botox is highly customizable! Introducing what I’ve dubbed “Protox” – custom Botox designed with your professional goals in mind. A personal brand identity is key to one’s career and the face often says it all.

The Case of The Lawyer

Attorneys must have the ability to look disapproving. This patient always needs to maintain a little corrugator movement (this is the muscle group that give you the vertical “11 lines” between the eyebrows, and furrows the brow) in order to successfully argue a case or negotiate a mediation.

When The Psychiatrist is the Patient

A Psychiatrist needs to maintain a sympathetic demeanor without displaying a disapproving, “frozen” look. In contrast to the lawyer, this patient needs to seriously weaken movement in the corrugators so they can relax and listen to what their patients are saying without looking judgy, but keep a little movement in the frontalis muscle (the muscle that raises the eyebrows) so they can still look like they care about what they’re hearing.

Let The Teacher Teach

He needs to maintain the ability to look surprised and to be sympathetic. This patient needs to retain almost all movement of the frontalis muscle that raises the eyebrows, but can often benefit greatly from Botox used to soften the crow’s feet and raise up the arch of the eyebrow.

The Poker Player

This patient needs Botox to retain her poker face and help eliminate the look of surprise (frontalis muscle) and some of the most common facial “tells” such as clenching the jaw and flexing the masseter muscle at the angle of the jaw. (masseter muscle Botox) It’s important for poker players to be able to keep all emotion under wraps.

The Actor Needs to Emote

Performers need to be able to express all emotions, but must also look permanently airbrushed with subtle touches of Botox in a number of areas.

No matter your personal or professional goals, subtle, natural, customized Botox is possible in the hands of an experienced injector!

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ThermiTight: Ready or Not

thermitight injectable radiofrequency treatment

Originally published on New York Social Diary. By: Delia von Neuschatz

——-

When you look in the mirror, do you pull back the skin on your face..

imagining what you would look like with a bit of tightening here and there? You may even have tried non-invasive firming treatments like Thermage and Ultherapy, but the sagging persists. Still, you’re not willing to go the surgery route just yet, but would like to do something. In that case, the minimally invasive ThermiTight, a procedure which sits in between non-invasive and invasive surgical alternatives — may be the right option for you. 

“ThermiTight is something for patients who see themselves getting a facelift down the road, but are not yet ready,”

explains Dr. Ron Shelton, a dermatologic surgeon who performs the treatment at the Laser & Skin Surgery Center of New York. “The ideal candidate is someone who is starting to see some drooping. The corners of the mouth are turning down and the nasolabial folds are deepening. It’s also a good treatment for patients who’ve had a facelift a few years ago and need a little tweaking.”

ThermiTight uses radiofrequency technology to both tighten loose skin and remove excess fat. It works by targeting the subdermal or inner layer of skin directly. “There’s such excitement about it because we’re seeing that the results can be very good,” says Dr. Shelton.

“ThermiTight has been a game changer,”

concurs plastic surgeon, Dr. Adam Rubinstein, who reports that the bulk of his patients for this treatment are 40 – 60 years old. “Before ThermiTight, we didn’t have an option for the in-between patient.”

In addition to tightening facial skin, this versatile procedure is also used to firm the skin on the neck, upper arms, abdomen and knees. And Botox users may be interested to know that a related treatment, ThermiRaise, disables the nerves which cause unwanted face and neck lines such as the glabellar or “11” frown lines between the brows.

Known as the injectable readiofrequency treatment,

Thermitight, which is FDA cleared, delivers heat directly to the dermis or the collagen-producing layer of skin through a very thin probe which, after an injection of a local anesthetic, is inserted just below the surface of the skin. When tissue is heated to 60° Centigrade (140° Fahrenheit), it contracts and produces skin-tightening collagen. Non-invasive radiofrequency treatments like Thermage, on the other hand, deliver heat through the outer layer of skin thereby limiting safe treatment temperatures and thus effectiveness.

The temperature of the treated tissue is carefully monitored. Not only does the probe measure the temperature of the underlying tissue several times per second, but the equipment also has a sophisticated external infrared camera which monitors skin temperature. “You don’t want to exceed a certain temperature underneath and you don’t want to exceed a certain temperature on the skin,” explains Dr. Shelton. The temperature is adjusted according to the desired results. Skin tightening, fat loss, nerve ablation all require different heat settings.

Although micro-invasive ThermiTight is non-surgical, it is not a treatment that entails less downtime than surgery, cautions Dr. Shelton. Patients can expect swelling and bruising to last one to two weeks. Compression garments must be worn for several days after the treatment.

non-invasive skin tightening treatments

Side effects may also include burns, nerve weaknesss (which disappears within a couple of weeks and which Dr. Shelton points out is also a hazard with surgery and Ultherapy) and theoretically, according to Dr. Shelton, there’s also the risk of facial asymmetry. Nor is this a “lunchtime lift.” Treating the face requires 45-60 minutes plus there’s the anesthesia time. Treating the thighs will take about two hours (not including the anesthesia time). Count on putting aside four hours for a two-hour procedure. You will also need someone to take you home afterwards.

Timing is a consideration in other ways. It takes six months or more to see optimum results so if you’re thinking of undergoing this procedure a month before your daughter’s wedding, save your money.

As for costs, they range between a few thousand dollars to about $8,000. To treat the face and neck, for instance, Dr. Shelton charges $6,500. One treatment is enough and results will last a minimum of two years. Ultimately, “ThermiTight doesn’t have any competition,” enthuses Dr. Shelton. “There’s a curve, but just about everyone sees tangible improvement,” says Dr. Rubinstein. “And sometimes, the results look like the patient has had a facelift.”

Want something a little gentler on your skin and on your wallet? 

Our beauty experts rave about the Sapelo Skin Care line consisting of a serum, a moisturizer, a moisture-locking emollient and a new eye cream: “The Sapelo Face Cream and Serum are really the best anti-aging products,” says Travel Beauty founder Alyssa Barrie. “It may take 28 days to see results but the results are amazing and the formulation is sensitive enough that it can be used as an under eye cream and on the neck. 99% of people that try this line, order again and again.”

Step one of the Sapelo Skin Care regimen, the Renewing Serum hydrates the skin and contains cell-stimulating growth factors, boosting collagen and elastin production. A touch of magnolia oil brightens the complexion; Step 2, the Rejuvenating Cream boasts a high concentration of five peptides including acetyl tetrapeptide-17 colloidal platinum which, in studies, has demonstrated improvement in skin elasticity by 47%, hydration by 33% and wrinkle reduction by 61%; Step 3, the Softening Emollient is packed with lipids, enclosing the ingredients from Steps 1 and 2 and preventing them from evaporating.

Expert tip

Alyssa recommends “taking the time to massage the cream and serum into the skin. It stimulates circulation and works the muscles under the dermis — similar to what massage does for the body. And for the neck, remember to stroke down, with pressure from the bottom of the chin to the décolleté. That is the direction of lymphatic drainage — strokes towards the heart. Many people are told that you are supposed to sweep up. It’s just not true.

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Non-Surgical Treatments for Under Eye & Cheek Areas

injectable under eye filler and cheek augmentation

They say the eyes have it. As I’ve gotten older, I’ve realized that “it” is my age. Every single year. Perhaps it’s because I have big eyes, but I feel like one night of crummy sleep can age me five years…or more. There’s the redness, the eyelid crepiness and–probably the most universal sign of raggedness–pitch black under eye circles. What to do, what to do?

I sat down with New York City plastic surgeon and Travel Beauty expert, Dara Liotta MD, to discuss how the face–specifically the under eye/cheek area–age, and what non-surgical options exist to make this aging process a bit more graceful.

“It’s not just wrinkles that age you”

Dr. Liotta said. “If you just ‘chase the lines’, you’ll end up with that obvious, overdone filler look. What can really age the face is volume loss and gravity, leading to a hollowed-out look. If you really want to look more youthful, you have to replace that lost volume.”  I asked Dara how volume loss ages the eye area, and she handed me a mirror. She instructed me to hold the mirror above my head and look up into it. “There are different components to under eye area aging, two are shadow and pigment. When you look up at yourself in a mirror, any shadow disappears, and all you are left with is pigment. No matter what anyone says, there is nothing you can do about pigment. No lasers, fillers or anything else will get rid of it.” (I frown slightly at this because, even looking straight up into the mirror, there is still some darkness underneath my eyes.)

“What you can treat with filler, however, is shadow”

I have some shadow too, so hearing this makes me happy. And hopeful. “Hollowness here [she points to under eye area] creates shadow, and a line right to the eye that draws attention and ages you.” Dr. Liotta said.

To reduce shadow in the under eye area, filler is added to the “tear trough”. This plumps up an otherwise hollowed-out under eye area that can become dark and thus, age us. “I only use Belotero for tear trough injections. It is the thinnest hyaluronic acid filler, which is so important as the skin under the eye is itself so thin. Other, thicker fillers can cause unpredictable swelling.” Indeed, search RealSelf.com for “tear trough reviews”, and you’ll read/see several horror stories of major, unsightly swelling as a result of thicker filler being used to treat tear trough hollowness. [This expertise is why I love Dr. L.]

What about this line that’s starting to form right through my cheeks?

I ask. This line, when coupled with pronounced nasolabial folds (the lines that form from the sides of the nose to the sides of the mouth), is what Dara refers to as the “thumbprint”, because the area between the two “lines” is the exact size of a thumb. She demonstrates by placing her own thumb between the non-existent “line” in her cheek and her non-existent nasolabial folds, but I get the idea.

“Well-done injectable cheek augmentation can take years off of your appearance. Since the skin is thicker in this area, I use Voluma here.” Dr. Liotta said. For those that aren’t on top of their injectable filler game, Juvederm Voluma is another injectable hyaluronic acid gel. It is the first and only FDA-approved filler that can instantly add volume to the cheek area. AND…since Voluma is a thicker filler, the results last two years! The amount of Voluma required for cheek augmentation varies between 1-4 syringes. “As we age, we tend to lose that youthful volume in the cheek area. Then, as gravity causes the natural fat pad of the cheek to drop, the nasolabial folds become more pronounced. By using Voluma to add volume back into the cheek area, you get a subtle, natural lift in the cheek that helps restore a well-rested, youthful look. This lift also improves the appearance of the nasolabial folds.”

Looking at Dr. Liotta’s before and after pics, it was amazing to see how much Voluma injected into cheeks improved the appearance of nasolabial folds–a different area of the face. The improvement is seen in the reduction of “shadow” on the side of the nose…the same reason women spend millions of dollars every year on highlighters meant to mask/minimize/erase such shadows.

I’m not ready to take the Voluma plunge yet

Dara swore I don’t need it yet–but it just might be my 40th birthday gift to myself!

I cannot recommend Dr. Liotta highly enough. As a Board Certified ENT surgeon, as well as a Facial Plastic and Reconstructive surgeon, she is intimately acquainted with, and comfortable manipulating, the complex anatomy of the face. That’s why I won’t trust my face to anyone else. To get more information and to schedule a consultation, visit Dara’s website.

By: Claire McCormack, Twitter & Instagram

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