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Juvéderm Voluma XC, a popular pick among plastic surgeons looking to add volume and contour to their patients’ cheek area, is now FDA-approved for the chin, too. The hyaluronic acid-based filler, one of several under Allergan’s umbrella of Juvéderm injectables, is the first and only filler of its kind to receive FDA approval for chin augmentation.

“When assessing facial anatomy, the chin is a critical component to facial balance, yet it is often overlooked. Due to its distinct gel properties and product profile, Juvéderm Voluma XC is uniquely suitable to address this need,” Carrie Strom, president of Global Allergan Aesthetics, said in a statement.

While the FDA’s approval is newsworthy, many plastic surgeons have already been using Juvéderm Voluma XC off-label in the chin area for patients who want to try out a chin implant without committing to one. In many cases, the patients are so satisfied with the results that they opt to continue getting injections of the filler and forego the implant.

Patients are attracted to the ease of the filler. In less than a half-hour, they can see themselves with a new chin, with minimal pain and bruising and virtually no downtime. An implant, by contrast, typically entails a week of downtime. And it can take several weeks for the swelling to fully subside.

That said, Juvéderm Voluma XC should only be considered for relatively subtle chin enhancements. Someone who’s seeking a little more definition or structure is a great candidate.

In conjunction with a rhinoplasty (nose job), both surgical and nonsurgical, chin augmentation with Juvéderm Voluma XC is an effective means of balancing a facial profile. For those who have large noses on profile, adding a little volume to the chin can make the nose appear smaller by comparison. Similarly, the procedure can also help diminish the appearance of jowls.

When used in the cheek area, Juvéderm Voluma XC has been shown to last up to two years. In Allergan’s own study of the filler as a chin augmenter, the majority of participants reported “high satisfaction” with their results up to a year later.

Learn some lesser-known truths about Liposuction. As fast as noninvasive body contouring is growing, liposuction continues to be even more popular. In 2018, liposuction was the second-most performed cosmetic surgical procedure in the United States, behind only breast augmentations. The number of liposuction cases had also grown five percent from the previous year.

For all the noninvasive body contouring options that are now available, not to mention a host of others that are on the horizon, none can deliver the dramatic results—not in a single session, at least—that liposuction can. And with techniques constantly improving, you may not necessarily need general anesthesia for liposuction, which is another big incentive.  For example, in our office we can perform FLASH – fat liposuction away same hour – a unique liposuction technique that can be done on your lunch hour with local anesthesia.  We talk the entire time!

But if you’re considering liposuction, none of the above is likely news to you. A quick Google search will tell you as much. What I’d like to discuss here are a few aspects of liposuction that aren’t as well-known, and we make sure our patients know.

Liposuction is not a weight-loss tool

Perhaps the biggest misconception is that it aids weight loss, which is understandable. After all, fat is being suctioned out through a small incision. Basic math, right? Not quite. Body contouring is different from weight loss. The best candidates for the surgery are those who are close to their target weight but who are having trouble with a particular area or two, like their abdomen or love handles.  You may lose some weight from having liposuction, but the change is generally minimal.

Liposuction won’t trigger an adverse reaction from your remaining fat cells

Somewhere along the way, the myth developed that liposuction triggers an adverse reaction from the body’s remaining fat cells. Namely, they’ll either spawn new fat cells or the cells in the treated area will wander the body and eventually regroup elsewhere. Neither is true. The number of fat cells in our system is set. So, once they’re gone from a specific spot, they’re gone for good. But our fat cells can fluctuate in size, which is why eating a balanced diet and exercising regularly are critical to maintaining your results following liposuction.

Liposuction won’t cause sagging skin

Developing loose skin around the treated area is another common concern about liposuction. If your skin is firm and smooth before the procedure, it’ll be that way after it, too. The collagen and elastin in our skin enable a certain amount of contraction and tightening of the skin. And even if you have some mild sagging beforehand, there are a number of skin-tightening treatments we have available, specifically where we use combination treatments with radiofrequency and liposuction. Any one of them can be employed once you’ve recovered from your surgery.

Liposuction yields great results—just not right away

Liposuction is capable of some fairly dramatic final results – and you may see some immediate results – but your procedure is always followed by swelling, which can minimize the effect of the surgery initially. The swelling will subside over the first couple of weeks after your surgery, your final contoured appearance is normally achieved three to six months after your procedure.  The recovery, though, always goes quicker than you think it will—as long as you enter into it with some patience.

If you wish to learn more truths about liposuction, please do not hesitate to contact Davis CPS — we are here to answer your questions.

Breast augmentations continue to be the most widely performed cosmetic surgical procedure in the United States. In the vast majority of those cases, I help women get the shapelier, perkier breasts they always wanted. But for others, their new breasts fall short of their expectations. In those instances, they can appear distorted and even result in physical pain.

A breast augmentation revision is a surgical procedure that addresses issues that stem from an initial breast augmentation. They can be concerns that are immediately apparent or develop later on. Revision surgery is also appropriate for women who were satisfied with their outcome initially, but whose desires for their body changed over time.

Poor positioning of the implant, bottoming out of the implant, incorrect implant size, and poor scarring are the most common reasons women pursue corrective surgery following their breast augmentations. In rare instances, implants can rupture, in which case we would remove any free silicone and scar tissue. At that point, we would normally replace the breast implants with new implants.

A condition called capsular contracture also prompts those affected to seek out a breast augmentation revision. Here, the tissue tightens and contracts around the implant, resulting in unnaturally firm and distorted breasts that can be quite painful. While the cause is unknown, several evidence-based methods have been shown to prevent it from recurring.

What does it entail?

Here at Davis Cosmetic Plastic Surgery, a breast augmentation revision involves removing and/or replacing implants, removing scar tissue, and/or restoring symmetry to the breasts. However, revision surgery tends to be more complicated than the original breast augmentation.

However, done correctly, a breast augmentation revision can safely provide a woman with the outcome she had in mind when she entered into her first surgery.

During the procedure itself, I will create incisions that we discussed during your consultation. Whenever possible, I try to use the incisions from the original surgery to minimize scarring. If necessary, the current implants are then removed and either replaced or the breasts are left without them.  We may also perform a formal breast lift, or a periareolar lift – moving the nipples back to where they are anatomically supposed to be – after we remove the implant. Any scar tissue will also be removed. In all, the surgery can take anywhere from an hour to three hours, depending on its complexity.

Typically, recovery is about six weeks, but most are able to return to work and their routines after a week or two.

How to find a surgeon

Because revision surgery is more complex than a standard breast augmentation, seek out a board-certified plastic surgeon who has extensive experience performing the procedure.

It’s also critical that your surgeon be a good listener. The consultation, always an essential part of the process, takes on even more significance here. Each woman has a unique aesthetic goal for her breast augmentation. Should you ever feel like your interests or concerns are being ignored, find another surgeon.

When your breasts are different sizes, it can cut deeply into your self-image. You’re constantly confronted with the reality, and each time, it may feel a bit more isolating. But know that you’re not alone. Breast asymmetry is very common. It’s estimated that it affects more than half of all women to varying degrees.

The condition stems from a variety of causes. And while there appears to be no reason to be concerned, physically, in most cases, the emotional toll shouldn’t be discounted. If you’re feeling particularly self-conscious or even depressed because your breasts are different shapes or sizes, know there’s a way to help. Corrective surgery could restore balance and proportion, not to mention your confidence.

Finding the right fit

Breast asymmetry correction refers to a number of techniques that can be employed to help you achieve your ideal shape and size. At Davis Cosmetic Plastic Surgery we set you up for a consultation and discuss which treatment, or combination of treatments will be used to correct the asymmetry of your breasts, listening to your personal goals.

Generally, both breasts will require correction. Large breasts, for example, may be reduced to a more proportionate size, but the amount of reduction might differ between the breasts if one is naturally larger than the other. An augmentation can be performed in a similar fashion, using different sizes of implants to create balance while enhancing the size.

With over 25 years of experience, Dr. Davis has extensive experience performing cosmetic breast surgeries. While all plastic surgery requires a meticulous attention to detail and an artistic eye, these qualities, which are honed through practice, are essential to creating proportionate, natural-looking breasts.

What to expect

The procedure is an outpatient surgery, meaning you’ll most likely be free to return home the same day as your procedure. Incisions will be placed in inconspicuous areas to minimize visible scarring. Commonly, that means either the breast crease underneath the breast or encircling the areola – all things discussed ahead of time during your consultation.

If your breasts are enhanced, an implant will be placed in your breasts. If you’re having a reduction or lift, excess skin will be excised and breast tissue will be removed to create perkier, shapelier breasts.

The typical recovery for breast-related surgery is about six weeks, but most women return to their normal routines and work within a week or two with little evidence they underwent surgery. And once you’ve fully healed, your results should be long-lasting.

If you’re tired of always scrutinizing your breasts, it’s time to take matters into your own hands and discover the life you deserve. It’s closer than you think it is.

What we nailed down in the previous post: Fine lines, wrinkles, and sagging skin—they’re coming for all of us, sooner or later. It’s just nature’s way. But that doesn’t mean they can’t be held off a while longer, or even reversed. There are lots of ways, both minimally-invasive and surgical, to go about that. These are a few of the most popular.

You’re just beginning to notice your laxity

Thermage and Ultherapy are considered the go-to treatments for mild skin laxity—you’re starting to notice the appearance of fine lines and your skin doesn’t quite bounce back the way it did in your twenties. Thermage employs radiofrequency energy to tighten the skin, while Ultherapy does it using ultrasound to create heat under the surface of the skin.

The downtime for both is relatively minimal, but it’s still more than it is for another, newer method called threading. Here, specially-designed, resorbable sutures are strategically inserted into the skin, lifting the tissue and tightening the skin in the process. The results are immediate. And while they’re temporary (six months to a year, depending on the sutures), the process has been shown to help boost collagen production, which bodes well for the long term.

You’re done blowing your budget on anti-aging creams

If your skin laxity is a little more advanced—your fine lines have evolved to wrinkles and you’re beginning to develop jowls—a facelift will deliver the most dramatic and longest-lasting results. Keep in mind, this is not your mother’s facelift. Today’s version is highly customizable.

But if you’d prefer to avoid surgery, a minimally-invasive, heat-based treatment called FaceTite is your next-best option. A probe administers electrical energy that heats the skin internally, tightening it in the process. ThermiRF and Renuvion act in similar ways, though through slightly different technologies. In each case, the downtime is minimal, and the results will last between two to three years.

Your sagging skin is weighing you down

In the most significant instances of skin laxity—you’ve had a baby recently or lost a lot of weight—surgery is your best course of action. There are minimally-invasive treatments available, but they’ll have a fraction of the effect that a tummy tuck would or a lift (be if of the arms, breasts, or thighs). The same goes for the face. A facelift will lift and tighten sagging skin, get rid of jowls and wrinkles, and restore the youthful face that feels more like you.

In my last post, I explored some different methods for improving a drooping brow. Neuromodulators, like Botox and Jeuveau, are generally quite effective on that front (among lots of others), especially in younger patients. But, as we lose some of the fatty tissue and muscle in our faces to aging, neuromodulators will lose some of their potency. At which point, it may be time to consider a brow lift.

A brow lift can serve other functions, too, including minimizing that furrow between your brows, known as the “elevens,” and shortening the forehead, which creates a subtly rounder, more youthful-looking face.

So, what is a brow lift, exactly? Let’s get into it.

A minimally-invasive technique

First things first: A brow lift is a cosmetic surgical procedure where the skin of the forehead is raised—it’s also referred to as a forehead lift—lifting a drooping brow, smoothing forehead creases and wrinkles, and giving the upper part of the face a younger, fresher look.

It’s sometimes combined with a facelift or upper eyelid surgery, but, depending on your desired results and the severity of your sagging, a brow lift can be plenty effective on its own.

There are several variations of the procedure. Some of are less invasive than others. Most of the brow lifts performed today are endoscopic, which is a minimally-invasive technique where the surgeon makes four to five incisions, each about three-quarters of an inch long, just behind your hairline. Then, they’ll insert a long, thin tube with a tiny camera and a powerful light on the end through one of the incisions. That will guide the surgical instrument that’s inserted through the other incisions to pull and lift the forehead tissue and anchor it in place.

The technique, which has a shorter recovery period than the more invasive methods, is ideal for those with minimal forehead wrinkles and mild to moderate skin laxity.

Long-lasting results

The first thing virtually everyone wants to know about an injectable or a surgical procedure is: Does it work? A brow lift does work, and you’ll be able to see a significant change right after the procedure. And that change will improve even more after a few weeks, when most of the swelling will have subsided.

As for how long those results will last, they vary, because a brow lift does not halt sagging skin. Alas, nothing does. But most can expect their new, smoother foreheads to last for about a decade. And that’s a significant upgrade over neuromodulators, which need to be replenished every several months.

The adage should really go, “There are three certainties in life: death, taxes, and skin laxity.”

It’s true; all of us will eventually develop some degree of skin laxity. For some, thanks to a combination of factors, that day may arrive sooner than it will for most. But that shouldn’t imply that there’s nothing you can do about.

Over the next two blog posts, we’ll unpack skin laxity, beginning here with what it is, exactly, what causes it, and how it progresses. In my next post, we’ll get into what you can do about it, from the mildest forms to the most severe. (Spoiler alert: There are lots of treatments, both noninvasive and surgical, to improve skin laxity.)

How you can slow your skin laxity

So, what is skin laxity—beyond one of those terms you’ve heard a bunch in passing? Very simply, it refers to the state of loose skin, which occurs as a result of the depletion of collagen and elastin. Think of collagen as the skin’s building blocks. Soon after we enter our twenties, our collagen production will begin to drop off by 1% each year. (Yup, that soon.)

Elastin is a protein that coils and recoils like a spring within the skin’s elastic fibers. When you pinch, tug, or smush your skin anywhere on your body, the elastin is what snaps it back into place. But right around the time we start losing collagen, we also begin losing elastin.

All of this is part of the natural aging process, but we experience skin laxity a little differently from one person to the next because a number of other factors also play a part, including, most commonly, genetics, sun exposure, diet, lifestyle, stress, significant weight loss, and smoking.

So, how well you’ve taken care of yourself can mean the difference between a few fine lines and a few deep wrinkles, at least early on. At a certain point, there’s no denying the inevitable.

The different types of skin laxity

Skin laxity is diagnosed according to one of three categories: mild, moderate, and severe. With mild, most typically notice subtle changes to the middle of their faces first. Then, as we move from moderate to severe, the skin around our necks will begin to appear a little crepe-y and we’ll start to form jowls.

In the recent past, surgery was essentially the only option for anyone who had entered the moderate and severe phases of skin laxity. Fillers offered an alternative, but the results, at that point, tended to look overdone or disproportionate. Which is why you may be a bit wary about the idea of seeking treatment. There’s no unseeing those images. But today’s treatments are far more precise, both in their application and their outcomes.

Thanks to advances in the methods and improvements in plastic surgeons’ skillsets, it is possible to reverse nature’s course without losing any of your natural beauty in the process.