Total Body Surgical Blog

A good friend asked me to talk about fillers this week and I promised I would, so here goes.

First of all, what is a filler and why would someone want to use one??  Fillers are just what the name sounds like.  As we age, we lose volume in our face.  We lose it around the eyes, in the cheek area, and in the folds around the mouth and lips.  This is caused by hormonal changes and in many cases, genetics plays a significant role.

  As you can see in this graffic, as volume is lost, the skin begins to respond to gravity and "folds" in typical spots start to form.  Nasolabial folds are the most common, forming around the base of the nose to the corners of the mouth.  Secondly, "bags" begin to form under the eyes.  This is due to shrinkage of the fat pads in the cheek area that, in younger people, "windowshade" the fat pad under the eye.  This creates the dark circle under the eye which is really shadowing, as light is blocked by the overhanging fat pad.  The other commonly effected areas are the "marionette lines" at the lower corners of the mouth and vertical lip lines.  One other common complaint is thinning of the lips and loss of the youthful shape of the lip.

This picture depicts the "cone of youth" and how aging turns it into a box.  Again, most of this is due to loss of volume and loss of skin elasticity.

Now that we have covered what happens, what can be done about it?  There are a few ways we can correct or reverse the aging process.  The first thing I recommend is good skin care.  It wouldn't be right to fix up a vintage car and not re-paint the thing would it?  You want your skin to look as youthful as possible and I think Obagi is as good as it gets for that.

Second, we have to increase volume.  Even when we do face lifts to remove excess skin, most of us will add volume to fill up the upper part of the face...this is youthful.

The first and best way to increase volume is with facial implants.  They are solid silicone and never go away....one time and that's it.  The second best way is with fat grafting.  We use your fat, process it, and place it back in the face.  This is good because it can last a pretty long time...5-7 years.  The third way is with fillers.

Fillers have been around quite a long time.  First came collagen fillers that only lasted about 3-4 months and required skin testing.  We now have them that last a year or more and can be used in anyone.  The most commonly recognized one is Juvederm.  It is made of cross-linked Hyaluronic acid (HA).  HA is a substance that is present between our cells naturally.  Juvederm is clear and almost jelly like.

  It can be used literally anywhere in the face.  We use it to fill the cheek area, the nasolabial folds, marrionette lines, and lips.  It can also be used to correct nasal deformities or acne scars.  Think of it as putting dirt in a hole in your yard without disturbing the grass.  It is used to fill deformities or add volume to the cheek area, the nasolabial folds or marrionette lines.  It can be used to make lips larger or reshape them.    The second type of filler non-occuring in the body and made of a calcium compound mixed with a sugar based carrier.  This filler is good for volumizing but can only be used in deeper tissues. 

Radiesse is great for liquid face lifts where we place volume into the cheek area, lifting the face and restoring volume.  It can be used in nasolabial folds and carefully in marrionette lines.  It cannot be used in lips or in the dermis (skin).  Most other fillers on the market are made of HA, regardless of the name, except Artefill (made of collagen and spheres of solid material) and Sculptra (made of a powder material that causes collagen to form).  These two materials are made to inject deeply and last 5+ years.  All fillers have advantages and disadvantages.  You must consult with your injector to know which one is best to get the result you want.

My preferences are for Juvederm and Radiesse, for shorter term fillers.  I use silikon 1000 for my long term filler as it never goes away.  I use it to make great looking lips that stay.  I do small injections a month or so apart to get the right amount of correction.  Hope this helps everyone.  We love fillers and do them very well.  Call today and come see me at 918-786-7780.  All cosmetic consultations are complimentary.

What does Christmas have to do with Cosmetic Surgery??? Well let's talk about it. 

Christmas is rapidly approaching believe it or not, it is only a few weeks away.  Now is the time to start thinking about gifts and what can be done for the new year.  Many don't think about anything Cosmetic, but let me help you change your mind.  Instead of that sweater, tie, or other gift that will be worn on Christmas day and then never seen again, how about giving something that can be seen every day!! There are a number of things that are affordable and can make you or your loved ones look and feel better.....much more useful than a sweater!!

First:  Laser hair removal.  We have pricing on laser hair removal that are the best in the country.  If you have young ladies in your life, this is a great gift.  At $50 per area per treatment you can give the gift that keeps on giving for about $300 per area.  No more razors, always ready for summer wear...what a gift.  For guys, we must bring this up carefully but if you listen well, the opening usually comes up so pay attention.  We can remove hair on the face, bikini area, and under the arms on women and for men, chest and back hair removal is all the rage.  Call the office at 918-786-7780 and we can get you a nice gift certificate to put under the tree!

Second:  Botox or dermal fillers.  Everyone has heard of Botox and many of us use it regularly.  It is a great help in reducing wrinkles in the face, stopping excessive sweating, and relieving headaches.  In many cases our loved ones are already using it so why not pre buy and save some money!!  We have special pricing on pre-bought Botox at $9 per unit.  If you figure the average number of units at 30, that is $270 per treatment....very affordable.  The treatments take about twenty minutes and last up to 6 months.  You can take care of his or her whole year with one gift certificate.  Dermal fillers like Radiesse or Juvederm can also be pre purchased at a special price.  These are used to fill nasolabial folds (the wrinkles between the base of the nose and the mouth) and marionette lines (wrinkles from the side of the mouth).  They last about a year.  We also do the so called liquid face lift that fills the cheek area getting rid of lines under the eyes and in the cheek.  This is very rejeuvenating and less traumatic than the real thing.  We are offering a syringe of filler for $400 (usual price $500) and if you purchase more we will lower the price on multiple syringes.  Either of these gifts will get you big kisses.  Call us at 918-786-7780 and we will get you a nice certificate.

Third:  Venous sclerotherapy.  This is the time to get rid of those ugly spider veins before we are back in shorts.  These treatments are done in the office and are fairly quick.  Normally we charge $350 per session but for Christmas, we will lower that price to $300.  What a nice gift to give....getting your legs back, being able to wear shorts again without embarassment.  For a nice gift certificate, call 918-786-7780.

Fourth:  Liposuction.  This can be a little more of a touchy subject but if your significant other is continually complaining about belly fat, saddle bags, love handles, muffin top, fat arms, any other area or combination of areas, they are asking for liposuction but don't know how to say it.  Smaller areas are perfect for liposuction with short recovery time and amazing results.  We have all the specialized equipment too.  Laser liposuction is amazing at helping tighten up the skin after removing the fat.  We will give you a 10% discount on the first area and a 20% discount on a second area.  That is up to a 30% discount on two areas of liposuction.  That means that you can give a gift that will change those complaints into complements.

Fifth:  Breast augmentation.  College students, wives, and girlfriends are always talking about having breast implants to improve self image by improving appearance.  What better gift to give.  We have the best pricing on silicone and saline implants right here in Grove.  Christmas is a great time to schedule and take advantage of the winter to heal up and be ready for summer. 

There you have it...some great ideas for Christmas gift that I guarantee will be appreciated.  Dr Miller and I or our nurses are also ready to help if you have questions about what is appropriate.  Call us today at 918-786-7780 and GET YOUR SHOPPING DONE early for once!!!!

Sorry about the late post this week!  Spent the weekend in Oxford, MS at the Ole Miss, Arkansas game.  Oxford is a great place to visit and I recommend it to all.  The game was fun.  One of my daughters went to Ole Miss and the other is currently a Hog!!!

This week we are going to discuss the unusual uses of fillers.  Last week I talked about the normal uses around the mouth and in the nasolabial folds.  I hope you all got to read it. 

There are a number of uses for fillers that are a little out of the main stream.  The first is in the nose.  There are a number of people that present with complaints of imperfections in the shape of their nose and they are not ready for rhinoplasty, OR, they have had a less than perfect rhinoplasty and have persistant defects.  In these cases I will use Radiesse or Silikon 1000 to help re-shape the bridge of the nose or fill defects.  With Silikon 1000 the fix is permanent and therefore I like to correct in stages so as not to overcorrect.  Fillers are a great way to a non surgical rhinoplasty.

A second out of the mainstream use of fillers is for cheek augmentation and filling the nasojugal fold....the line we get below the eye from the corner of the eye onto the cheek.  This is done in those that do not want an implant or fat grafting.  The filler is essentially placed where an implant would sit over the cheek bone.  It is a great way to rejuvenate the mid face without surgery.  It is done in the office and usually requires several syringes of product.  I usually use Radiesse as it offers more volume per syringe for the same price.  I like to call this the liquid face lift.  It is not perfect but does do a good job.

The third use is in rejuvenating the hands.  As we age, we not only lose fat in the face, we also lose it in our hands.  Many times we work on our face and body then forget the hands. Hands age quickly due to sun exposure.  Fillers or fat can do a great deal to make the hands look much younger.

The fourth place is for acne scarring.  Laser resurfacing can do a great deal to smooth out scarring that occurs from acne.  When they become too deep for the laser....fillers can help.  I usually use Juvederm or Silikon 1000 in very small amounts to help level these areas.  In some cases subcision or release of the scar must be done first and this is done in the office with some local anesthetic.

The last place I will talk about for fillers is the lips.  Believe it or not....they get smaller too!!  Adding volume to the lips is a great way to rejuvenate.  Voluptuous lips are what all the girls want!!  I like to use Juvederm, and for those who want a permanent fix...Silikon 1000 in a gradual fill.  Both are great and can make you look outstanding....

Enough about fillers I think.

Remember our special offers on fillers, liposuction, lap bands and treatment of toe nail fungus!!

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