The UK’s Telegraph reported on October 12th that physicians in England are developing a technique to mix stem cells with fat for transfer into the face. This modified technique of fat transfer re-fills the face. The stem cells increase the potential for survival of the transferred fat and rejuvenate the skin by increasing it’s blood supply.
Until this technique is available, filling with Sculptra, Radiesse, and Juvederm provides natural, lasting results.
Lasers have revolutionized the field of dermatology and the way we treat skin. They can even skin tone, smooth skin texture, and reduce wrinkles and scars. Picking the right laser for you depends on what you want treated and the individual characteristics of your skin. Unfortunately, there is no single laser that treats everything.
If you have signs of sun damage, such as sun spots, uneven pigmentation, and dilated blood vessels, treatment with an IPL Photofacial may be best. Usually, a series of 3 – 5 treatments are needed for optimal results. There is no downtime. Risks include burns and scars, so treatment should be performed under the guidance of a board-certified dermatologist.
If you have wrinkles or scars, the best laser treatment seems to be fractional resurfacing. However, this treatment has downtime and may not be right for everyone. Also, fractional resurfacing alone may not provide optimal results. The best results often come from combining various types of treatments including Botox or Dysport and fillers.
If you have dark spots on your face called melasma, lasers are usually not the best first choice. Sometimes, IPL treatments can even make melasma worse. Starting with strict sun protection, a prescription bleach, and chemical peels usually combines the highest potential for benefit with the lowest risk.
As you can see, there is no single laser that is best for everyone. The best treatment for you depends on many factors and is as unique as your skin. In face, we have found, at our Los Angeles dermatology and liposuction practice, that while lasers are amazing tools, they are not always the best choice for treatment.
The abdomen is the most common area for liposuction, and it is common to have an overhang of fat on the lower abdomen or fat that bulges out over a c-section scar. A lot of people want to know if removing this fat will leave them with a loose, hanging flap of skin.
The answer is almost always that they will not be left with a loose flap of hanging skin. Skin retracts to some degree after liposuction as a result of the natural elasticity of skin and because the healing process after liposuction induces retraction.
However, some people may be left with a certain degree of crepe-like looseness that doesn’t hang depending on the quality of their skin before liposuction. Sun damage, a history of repeated stretch, or visible stretch marks are signs that your skin has lost some of its elasticity. The less elastic the skin to begin with, the looser it will remain after liposuction.
The question then becomes whether or not a tummy-tuck (abdominoplasty) would be a better option. The main question to answer to determine which treatment is right for you is, “Am I willing to go through the extra cost, risk, and recovery of a tummy-tuck, or would I be happy with a flat stomach that has a certain degree of laxity to the skin?” A tummy-tuck is without-a-doubt more expensive, dangerous, and painful than liposuction alone, especially if the liposuction was done without sedation using only local anesthesia.
Most people who I meet in my Los Angeles liposuction practice who are at risk for developing loose skin after liposuction are looking to get liposuction in the first place primarily to give them a flat stomach so they look good in their clothes and fit into the clothes they want to wear. They are usually not planning on wearing a bikini and are willing to accept a certain degree of loose skin after liposuction versus the increased risk, cost, and large scar from a tummy-tuck.
The amount of skin tightening that occurs after liposuction is difficult to predict. It is easy to assume that people with a lot of stretch marks and very poor skin quality will have the most loose skin after healing, but even they get a surprising and dramatic amount of tightening sometimes. It is best to consult with an experienced liposuction surgeon to discuss your possible outcome.
As a final though, it should also be noted that it is possible to have a tummy-tuck after you have had liposuction. Having liposuction does not prevent you from having a tummy-tuck in the future.
Pregnancy is a very special time, and many people wonder if having liposuction now will have any negative effects on pregnancy in the future
Although this question has not been formally studied, as long as you have fully recovered from liposuction, there are no known negative effects on your ability to become pregnant or pregnancy itself.
If you are not planning on becoming pregnant right away, there is no need to postpone liposuction to remove unwanted pockets of fat. If looking great now would help you feel great now, then go for it!
At our liposuction Los Angeles office, we perform liposuction using local anesthesia only. This is called tumescent liposuction and is the least invasive form of liposuction.
I often hear this question from prospective patients at my Los Angeles liposuction practice. The answer is that it depends.
Liposuction traumatizes the fat during removal, and swelling develops as a result of this trauma. Although it is safe to say that swelling can take up to 6 months to resolve, it can diminish much faster than that depending on the technique used, the individual healing characteristics of the patient, and the amount of fat removed.
In terms of technique, adequately infiltrating the area to be suctioned with anesthetic, using microcannulas, and leaving the entrance ports to drain under compression after the procedure make the biggest differences.
To ensure adequate infiltration, I use liposuction using local anesthesia only. I also only use microcannulas which are very small versions of the suction tubes used to extract the fat. The smaller the tube, the less trauma there is.
Compression after surgery forces the excess fluid out of the entrance ports made during surgery. These are so small they do not require stitches.
Swelling generally lasts longer when a lot of fat is removed. In my experience, swelling also seems to resolve faster in certain areas, especially the arms.
Using these techniques, I tell prospective patients in my liposuction Los Angeles practice that, for most people, the great majority of swelling will be gone by 6 weeks but some residual swelling may last for up to 6 months. However, I’ve never had a patient whose area was bigger from the swelling than it was before surgery.
Dark circles under the eyes are a common complaint, and their appearance is likely due to multiple factors that include genetic hyper pigmentation, excess pigmentation due to inflammation from allergies/eczema, swelling, thin skin allowing blood vessels and eye muscles to be visible through it, and anatomical changes leading to shadowing such as depression of the tear trough. Each one of these causative factors needs to be addressed for maximal improvement.
To treat hyper pigmentation, one may benefit from chemical peels and the regular use of sunscreen and bleaching creams. If the increased pigmentation is due to inflammation from allergies or eczema, then the allergies or eczema need to be treated.
Muscles and blood vessels are dark in color, and they impart a darker tint to the overlying skin when they are able to be seen through it. Thin lower eyelid skin is difficult to treat, but chemical peels and prescription creams such as tretinoin (Retin-A) can help. Thick skin is less transparent.
Anatomical changes that lead to the appearance of a shadow under the eye include a depression in the groove along the lower eyelid. This groove is known as the tear trough. When this groove extends onto the cheek it is because the fat pad that creates the apple of the cheek has descended. These anatomical changes occur with age. The tear trough can be filled with products such as Restylane and Juvederm. In my experience, this is a very rewarding procedure. The cheek can be re-volumized with many different products, but one of my favorites is Radiesse for cheek augmentation. Protrusion of the fat pads directly behind the lower eyelid often need to be addressed surgically if they are very prominent.
In my Los Angeles Dermatology and Liposuction practice, patients often ask me what they can do about dark circles under their eyes. Although it is not always possible to completely eradicate them, many people can achieve significant improvement if the individual factors causing them are addressed.
Excess underarm sweating can be debilitating. Prescription antiperspirants and Botox for sweating can help, but here’s a tip for getting results with over-the-counter “prescription strength” antiperspirants.
These are products like Gillette Clinical Strength and Secret Clinical Strength.
Instead of using these antiperspirants in the morning like most people do, apply them to clean and dry skin both morning and night. One study evaluated 60 women and found that antiperspirant applied twice per day was more effective than application in the morning or night only.*
Of course if over the counter antiperspirants don’t work despite applying them twice per day, there are prescription products and Botox available. At our Los Angeles dermatology practice, we are able to prescribe strong antiperspirants and regularly administer Botox for hyperhidrosis.
* Swaile DF. Clinical comparison of antiperspirant efficacy as a function of morning and/or nighttime application. Journal of the American Academy of Dermatology. 2004 Mar;50(3);p77.
After years of waiting, there is finally an alternative to Botox Cosmetic. It is called Dysport, and, like Botox, it is botulinum toxin A.
Dysport recently received approval for medical and cosmetic use in the United States. Although it is new here, it has been used for a number of years outside of the US, and the medicine is 18 years old.
There are some differences between Botox and Dysport even though they are both forms of botulinum toxin A. The molecule of Dysport is smaller in size than that of Botox. This may account for the observation that Dysport spreads farther in the skin after it is injected. Also, more units of Dysport are needed per injection than Botox to achieve the same desired result. The company that distributes Dysport recommends a conversion ratio of 2.5 units of Dysport for every 1 unit of Botox.
Another difference between the two products may be in how long their effect lasts. One study comparing Dysport to Botox found that Botox seemed to last longer.
A separate issue is the potential to develop proteins against these products called antibodies. Proteins against Botox have been reported which may account for the observation that some people become resistant to treatment over time. The US distributor of Dysport reports that no antibodies developed in patients receiving Dysport in clinical trials even after 9 treatments.
What these differences mean in the real world remains to be seen and will probably be discovered after a few months of use. Medicis, the distributor of Dysport, expects to begin supplying Dysport mid-July. The exact date of distribution will depend on how quickly the medicine passes through customs since it is being imported.
For those residents of Los Angeles, I will have Dysport in Los Angeles available in my Los Angeles liposuction & dermatology practice as soon as it is available.
Latisse is the first FDA-approved medicine used to grow eyelashes.
Latisse is applied to the upper eyelashes daily using a sterile, disposable applicator. If treatment is stopped, eyelashes return to the length they were prior to treatment.
The active ingredient in Latisse is called bimatroprost, and it was discovered to grow eyelashes accidentally after patients using this medicine to treat their glaucoma noticed that their eyelashes grew.
Side effects of Latisse include eye redness, itchy eyes, darkening of the eyelid skin, and, possibly, permanent darkening of the colored part of the eye.
Latisse is manufactured by Allergan.
To learn more, you may visit our website at www.drosman.com or schedule a consultation if you live in Los Angeles for Latisse in Los Angeles.
Evolence is a new collagen based dermal filler. Collagen is the most abundant building block of our skin and is lost during the aging process. Evolence is strategically placed into the dermis, like other fillers, to enhance and maintain the natural structure and volume of our skin.
Unlike other fillers such as Restylane or Juvederm that are made of hyaluronic acid, Evolence Los Angeles is composed of collagen. The collagen structure of Evolence tends to cause less bruising and swelling than the hyaluronic acid fillers making recovery quicker and easier. Unlike older collagen fillers, Evolence does not require skin testing prior to use. This means you can get treated right away.
As a board-certified dermatologist in Los Angeles experienced with many fillers, I offer Evolence in Los Angeles.
