Total Body Surgical Blog

Last week we talked about eyes, the window to the soul.  Today we are going to discuss another part of the anatomy that can instantly tell your age.

Youthful lips are generally very full and inviting.  They are made of the white line where the skin and the pink mucosa of the lip join and the fullness of the lip takes off.  The cupids bow is in the center of the upper lip giving definition and contrast that the lower lip is missing.  Usually the lower lip is slightly larger than the upper.  Youthful lips are smooth and surrounded by skin that is also smooth with uniform color and texture.

  So what happened??  A number of things.  Skin aging, sun damage, volume loss, i.e. fat, around and in the lip, smoking, using straws, smiling, frowning, kissing and just time.  All of these things age our entire face but since the mouth is one of the centers of motion and expression in the face, like the eyes, it shows the use as we age.  The lips become thin and surrounded by vertical lines, nasolabial folds, marrionette lines.  The "white line" becomes less visible and the "cupids bow" becomes a straight line.

How can we repair the damage??  We can lift the tissue around the lips, correcting the cheeks and neck.  We can correct the nasolabial folds by adding volume in the form of a filler (Juvederm, Radiesse, fat grafting).  We can do dental correction to improve the underlying structure if needed.  To correct the skin damage, it is important to improve the skin.  We can do this in a few steps.  First, good skin care is critical.  As stated here before, we recommend Obagi products that combine Tretinoin and hydroquinone to correct color changes and improve the texture of the skin.  We then can augment the lips using temporary fillers like Juvederm or more permanent fillers like Silikon 1000.  This replaces the volume that has been lost.  Lastly, after pre-treating the skin with Obagi and repairing sun damage, the deeper wrinkles and vertical lines remain.  What to do about them?  They can be filled if extremely deep, again, with a temporary filler.  The best way to treat the area is with laser.  Resurfacing the area promotes new collagen production, softens the wrinkled areas, and removes the sallow color of the skin.  I usually recommend doing the entire face along with the area around the mouth.  This removes transition zones and looks more uniform.  We use the Pearl laser which is great for this.  It has a faster recovery time than similar lasers, can be spread over multiple treatments, and gives great results.  The price for the first treatment is only $1000 and repeat treatments are $500.  Most require 2 or 3 treatments for a great outcome.  The order should be, skin care, laser, then filler as some laser treatments can degrade the filler material.

Come see us for lip rejuvenation.  We carry a complete line of Obaji products and fillers.  Also Botox that can help prevent some of these changes.

Don't forget our other specials too....summer is approaching rapidly!!  Breast augmentation starting at $3799.00!

  Last week on the Total Body Surgical Cosmetic Surgery blog we talked about wrinkles and how good skin care and Botox can make a big difference.  This week we will take a look at the common fillers that can be used.

Below is one of the commonly used scales to measure and quantify the severity of wrinkles and skin damage.

Class II we would usually use Botox or Dysport because slowing the underlying muscles will usually eliminate the wrinkle as long as it is maintained.

Class III wrinkles will usually require "filling" as they are present at rest and are more or less permanent fixtures.  Filling them will not remove the wrinkle 100% but will go a long way toward making them tolerable.

There are many fillers on the market and thank goodness most of them now last a year or more.  This is in contrast to only 5 or 6 years ago when a filler would work for 2-4 months.  Many techniques can be nearly peramanant.

Hyaluronic acid fillers such as Juvederm and Perlane are great all around fillers that can be used nearly anywhere in the body.  This is because it is a naturally occurring substance in the body and is colorless.  They cause very little collagen production and the newer ones contain lidocaine which is a nice plus for the patient and injector.  These are the most widely used products.

Radiesse is another filler that is made of small calcium hydroxyapetite beads in a sugar based carrier.  This filler is limited in its use and should not be used in the lip or superficially anywhere.  It is great for larger volume fills in the cheek and nasolabial fold.  It works by causing your body to form collagen in the treated areas. It should last 12 to 18 months but will need some supplementation in that time.

Other common fillers are Sculptra which is poly L lactic acid can be used to create volume in the cheeks but this is a much slower process than the other two.

More permanent fillers are fat and silicone.  Fat harvesting and grafting has become common all over the body, but is very popular in the face.  Fat is harvested, treated and placed in areas where fat has disappeared over time.  There is some variability in the percentage of the fat that lives and therefore the procedure may need repeating. Lastly, silicone.  Silicone has received a bad name.  There are countless examples of low grade silicone used in too large a quantity to create a terrible result.  At Total Body Surgical, I have a great deal of experience with silicone.  We use only the best quality silikon 1000 that is manufactured by Alcon and made for use in the eye.  It works great for augmenting lips, filling areas of imperfection on the nose, and some acne scarring.

Next week....we'll address pigment issues!!  Come see us at Total Body Surgical.  Mention this blog and get $10.00per unit botox....That's a good price now!!