How to Get Rid Of Those Facial Parentheses (Nasolabial Folds)
One of the most common facial areas that bothers many patients is the development of the nasolabial folds, also referred to as the lip-cheek groove, or in a recent television commercial known as the parentheses. You can argue whether it is a fold or a groove but it is probably closer to a fold. It develops as the cheek tissue from above ages and begins to sag….falling over its border with the upper lip. The upper lip is ‘fixed’ so the overhanging cheek tissue creates the appearance of a deepening fold. With time, aging, and the anatomy of one’s face, this nasolabial fold extends south past the corner of the mouth and sometimes nearing the lower border of the jaw in extreme cases of skin laxity.This area is commonly treated by injectable fillers and in my practice as many patients wants their nasolabial folds treated as they want their lips enlarged.
The most common method for nasolabial fold reduction is with injectable fillers. Like all filling procedures by injection, the results from nasolabial fold reduction is quick, easy to do, and the results are immediate. I usually perform them under a local anesthetic block so the treatment is as comfortable as possible. While all of the injectable fillers will work, I think some are better for this area than others. And the ones that I think are best are those that last the longest and have the greatest ‘push’.
While all of the hyaluronic acid fillers such as Restylane or Juvaderm will work, they do not last as long as any of the particulated injectable fillers. Currently Radiesse (ceramic beads) and Artefill (plastic beads) are the only two particulated fillers currently available. The evidence is clear, not surprisingly because of their solid bead component, that they consistently last longer than any of the hyaluronic acid fillers. While beaded injections can cause lumpiness and irregularities, this is not a significant cosmetic issue (nor can it usually be seen) in the forgiving area of the nasolabial fold. Conversely, in the lips this is a different matter. Also, because the bead composition makes the injectable material more thick and viscous, I think it provides more push as it goes in resulting in a better cosmetic effect and having to use less injectable filler. Because of particulated fillers longevity and thicker volume, it is my preferred injectable approach to the nasolabial folds. This injectable treatment will give a 9 to 12 month result.
There are other treatment options for the nasolabial fold as well. The best way to eliminate them is the one way which is almost never done….cut them out. That gets rid of the fold immediately but also leaves a fine line scar which may only be acceptable in an older patient. The other more commonly done alternative is to use an implant. I specifically use an Advanta implant for those patients that want a permanent volume solution. A very small incision is made in the nose crease and at the end of the lower fold line. The implant is slide into place from one end to the other. This is a procedure that can be done in the office under local anesthesia. An implant approach to the nasolabial fold is a good solution for someone who no longer wants to do injections, doesn’t mind the concept of an implant in their face, or has very deep nasolabial folds which would take a lot of injectable filler volume. My experience with an implant in this area has been quite good but it is not a first line approach for most patients.
Fuller Lips – How Lip Enhancement Works
Aaaahhhhh, fuller, younger looking, pouty lips. Full lips are definitely a sign of “youth” but what happens to our lips when we begin to mature? Lips become thinner, less attractive and pretty soon, one just might give up wearing lipstick because the top lip virtually disappears, especially when smiling. When this shrinking act is apparent in the mirror, usually vertical lines begin to invade the lips making a mature women look positively ancient.
Women aren’t the only ones who want softer, fuller lips. Men whose lips are thin and hard may portray a steely attitude in the boardroom; however, men with fuller lips look more attractive, boyish and younger.
Lips are soft tissue and as a man or woman begins to mature, volume dissipates which means tissue shrinks.
There are many modalities for revitalizing soft tissue in lips; the old standby – bovine collagen, Zyderm® and Zyplast® has competition. Restylane®, CosmoDerm® and ComoPlast® (human {cadaver} collagen), Radiance®, Artecoll® and others have entered the market of “fillers”. These new fillers do not require skin testing for allergic reactions and they are all injected. The procedure time varies from 3-10 minutes and some patients relate that these types of injections can be painful. These services can be relatively expensive because they’re not permanent fixes and these injections must be repeated every few months to maintain lip fullness. The most common side effect, as with any injection, is redness, bruising and swelling at the injection site that typically last less than three weeks.
A more permanent lip procedure that is widely used is Gortex. Strips of Gortex (threads of foam-like material) are inserted into the lips; the lips do become somewhat larger after the procedure is completed but some users complain that their lips feel hard, not soft and supple. Some of these implants cannot be removed if a problem arises because the lip tissue grows into and around the implant. Possible complications include infection, migration or extrusion of the implants and lip asymmetry is a concern.
Another somewhat permanent solution is fat injections; a patient’s own fat is removed from usually the tummy or buttocks, washed and then re-injected into the lips. While this is probably a fairly safe modality, the fat tends to reabsorb rather quickly, deflating the lips.
Recently over the counter glosses, lipsticks, and other types of topical preparations have been introduced promising fuller, poutier lips with more definition and volume. Many cosmetic companies have jumped on this bandwagon promising the users that their special ingredients will produce full, luscious lips after a few weeks of use. In fact, there have been over 200 new products introduced to the marketplace in the last two years ranging in price from $6.99 to almost $40. Instead of traffic stopping lips, some of these topical products have produced burns, mouth sores and empty pockets.
Some cosmetic companies do use natural components in their formulas but some of the formulas may be misleading. No product can deliver the look of a collagen injection in a topical. How these products work is through the use of an irritating ingredient such as niacin, cinnamon, caffeine or peppermint; these ingredients may cause some temporary swelling via dilation of the blood vessels along with mild inflammation, giving the illusion of fullness. Some preparations require the user to rub the lips briskly for several minutes and this friction results in some degree of temporary swelling.
Many women and men want fuller lips because poutier lips make them feel sexier and more alluring. Consumers are willing to spend a lot of money to have “the look”; but not everyone agrees that the topicals deliver what they have promised. Dr. Sam Most, Chief of Facial Plastic and Reconstructive Surgery at the University of Washington in Seattle asked seven women to use a certain topical whose website says their product increases actual lip volume and contour an average of 40.7 percent; Dr. Most said, “In subjects who used the product as directed over a long term there was no visible change in the lips.”
Is there an actual difference in using topical applications that promise full, pouty lips or is lipstick and a liner enough? Maybe Yoki Ono, a saleswoman at a Madison Avenue designer boutique, quoted in the NY Times, has the answer: “You might as well get some extra-spicy Buffalo wings and eat them.”
Or better yet, save yourself a bundle of cash and brush your lips with a baby’s toothbrush and petroleum jelly for about a minute, your lips will be fuller and soft – guaranteed!
An Introduction to Cosmetic Dermatology by Dr. Van Dyke
Susan Van Dyke, MD of Van Dyke Laser & Skin in Paradise Valley, AZ reviews the essence of anti-aging and solutions through cosmetic dermatology. She briefly touches on injectables, including fillers(Restylane, Perlane, Juvederm) and neuromodulators (Botox, Dysport), and cosmetic lasers (Fraxel, Thermage, Lightsheer, Active Fx) www.vandykelaser.com
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Sleep Wrinkles – Preventing and Repairing Them
As we age, the appearance of sleep wrinkles, those facial lines that develop from sleeping with your face against a pillow, becomes much more prominent. This should come as no surprise if you consider how much of one’s life is spent sleeping. If you are getting the recommended 8 hours of sleep per night, you sleep 1/3 of your life. Consequently, by age 60, you will have slept 20 years. It is obvious why sleeping on our face eventually leads to creases that become permanently etched in the surface of the skin. Sleep wrinkles are much easier to prevent than they are to repair. As a result, you should make every effort to keep from getting them in the first place.
The most effective and least costly method for preventing sleep wrinkles is to sleep on your back. People who sleep in this position simply do not develop these wrinkles. Chinese women recognized this fact ages ago, and always slept on their backs using concave porcelain pillows. If you are unaccustomed to sleeping in this position, you might try placing a pillow under you knees to decrease stress on the lower back and increase your comfort.
If you are unable to sleep on your back, using a pillow that minimizes facial wrinkling is another possibility. Sleep on a big, soft, non-synthetic pillow that you are able to fluff and squish. Those with natural fill, such as down and feathers, offer the most comfort, long-term performance, and adjustability. This type of pillow supports the head while providing softness, eliminating pressure points, and increasing facial circulation to reduce squashing and sleep wrinkles. There are also pillows available made specifically for preventing sleep wrinkles. They support the head while keeping the face and eye tissue away from the pillow.
Choosing the correct pillowcase on which to sleep can also deter the formation of sleep creases. If you awaken with these unsightly lines in the morning, your cotton pillowcase may be to blame. Instead of cotton, sleep on a silk or satin pillowcase that allows your face to slide across the pillow thereby minimizing skin wrinkling. Another option for not only preventing sleep lines, but also repairing those which you already have, is to use a copper technology pillowcase. It is imbedded with copper micro fibers which serve to repair your skin as you sleep. Copper has been proven to stimulate collagen production thereby helping reduce the appearance of lines and wrinkles.
Unfortunately, if you already have sleep wrinkles, they may be difficult to alleviate. As we age, our skin loses its elasticity. When the skin becomes creased while sleeping, it no longer readily snaps back when the head is not resting on the pillow, as it did when we were younger. Since these wrinkles are not the result of muscle contractions, such as worry lines or crow’s feet, products with Botox-like benefits are ineffective. In order to correct them, new collagen needs to form under the wrinkles to push up the skin from below. There are many skin care products on the market that contain various peptides that promote the formation of collagen. If topical formulations are ineffective, you might want to consult your dermatologist about a wrinkle filler such as Restylane.
Dr. Bill Johnson performs Thermage Procedure on THE DOCTORS – Innovations Medical
www.innovationsmedical.com Dr. Bill Johnson of Innovations Medical in Dallas, TX was a featured expert on the new hit show, THE DOCTORS. Dr. Johnson introduces the brand new (set to be released in January 2009) THERMAGE 16cm2 tip. This new tip is a huge advancement in the Thermage technology, allowing what once took 3 hours to do, in less than 1 hour. Watch as the patient’s abdomen is reduced by inches within an hour. For more LIVE Thermage procedures, please visit Dr. Johnson’s website at www.InnovationsMedical.com For more information about this brand new Thermage procedure please visit http or call: 972.331.8844 Dr. Johnson was the1st to offer the new Thermage tip to the public in November, pre-national launch. Innovations Medspa has performed the most Thermage 16.0 Procedures in the United States. a thermage, best thermage, city thermage, cosmetic thermge, cost of thermage, eyes by thermage, tummy by thermage, side effect of thermage, the thermage, thermage, prices of thermage, dallas thermage, ft. worth thermage, texas thermage, thermage in dallas
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