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You probably know about Botox. You may even be aware of the fact that there are other botulinum toxins—even though just about everyone, aside from board-certified plastic surgeons, refers to them as Botox, the same way you may refer to all tissues as Kleenex. But have you ever stopped to wonder what the difference is between Botox and the others? Lindsay Kirkman has, and she wrote about it recently for RealSelf.

In fact, she went further than that. She had Botox injected into one half of her forehead and Jeuveau, the newest of the four botulinum toxins approved by the FDA, injected into the other. Interestingly, of the three not named Botox, Jeuveau is the first to be formulated with the same 900 kDa molecular weight as Botox. The similar chemical composition should mean that Jeuveau’s results would most closely resemble those of Botox.

Kirkman cites one study that showed that Jeuveau could even begin working sooner and last longer than Botox. That said, how long a botulinum toxin treatment lasts depends more on the person than the toxin because how we metabolize it varies from person to person.

As for Kirkman, she had 18 units of Jeuveau injected into the left side of her forehead and the crow’s feet (the wrinkles etched into the corner of the eye) on the left side of her face and the same amount of Botox injected into the right side of her forehead and the crow’s feet on the right side of her face. 

“Ultimately, the pain level on both the Jeuveau side and the Botox side was exactly the same—as in very minimal,” she writes. “I felt a slight pinch every time the needle went in, but the tingly feeling went away within seconds.”

A couple of days later, the Jeuveau had “clearly” taken effect, Kirkman writes, while she hadn’t yet noticed a response from the Botox. That changed on Day Six. “The Jeuveau side feels even more locked in place, but for the first time, the Botox side has also started to produce that feeling of muscle immobilization,” she writes. “I can also tell that my brow lift has started to kick in—again, even more so on the Jeuveau side, where I’m seeing more of an arch start to form.”

Two months out, she writes, “Now when my face is at rest or when I am smiling, the lines on my forehead and between my brows still look equally smoothed out on both sides.

“However, in order to go beyond my own general observations in the mirror, I also asked my husband and a few friends to weigh in. All parties pointed out that as I naturally engaged in conversation—particularly when I looked surprised or curious—there were more obvious lines starting to reappear near the temples on the side of my face injected with Botox,” Kirkman says. “The difference is subtle enough, though, that I don’t think it’s anything anyone else would notice without specifically paying attention.”

If nothing else, it’s always good to know you have options. Comparable options.

If hyaluronic acid isn’t already a household name, it’s right on the cusp. It features prominently in a growing inventory of popular serums, sheet masks, and moisturizers.

It’s a sugar molecule that occurs naturally in the skin and binds to water to plump up your skin and make it somehow look dewy and like it’s glowing all at once. Natural hyaluronic acid is bound to collagen on one side and linked to water molecules on the other, which is what gives skin its plumpness.

Trouble is, as we age, we lose both collagen and hyaluronic acid naturally, which means our skin becomes dehydrated more easily. Our faces can also start to look a bit deflated, as a result.

Picking up where nature leaves off

The aforementioned products have been shown to increase moisture and even firm skin around the eye area and soften fine lines on the rest of the face. Hydrating skin-care ingredients—think glycerin, urea, propylene glycol, and sorbitol, among others—act as humectants, attracting water to the skin in an effort to hydrate it.

As an ingredient, hyaluronic acid does that and more. It can lock in moisture from the environment and deeper dermis, enhancing the hydrating effect. And that effect is more pronounced in those who are middle-aged and older, since our bodies are producing less of it.

Going even deeper

You may also recognize the injectable version. In dermal fillers, hyaluronic acid is a gel-like product that attracts water to the injection site to regenerate volume and recreate lost structure, reducing the face’s deflated appearance and softening the overall look of lines and wrinkles.

These fillers can address a range of concerns, including the nasolabial folds, marionette lines (the folds that run vertically from the corners of the mouth down to the chin), cheek augmentation, under-eyes, lips, and the tops of the hands. But one filler does not fit all. Yes, they’re all made up of the same ingredient, but depending on the size of the formulas’ molecules and how they’re structured, they vary in density, lift-ability, and longevity. So, finding a board-certified plastic surgeon with extensive experience with dermal fillers is critical.

Aside from their versatility, hyaluronic acid fillers are a good way to dip a toe into cosmetic plastic surgery for the uninitiated because they’re minimally-invasive, require very little, if any, recovery time, and they’re reversible.

If you’re not happy with the results, your plastic surgeon can insert an enzyme called hyaluronidase to dissolve the filler within a matter of minutes. Minimal risk and a potentially big reward.

Though it’s too soon for any formal research on the pandemic, many moms have said anecdotally that they’ve been feeling the strain. “I feel like I have five jobs,” one mom told The New York Times.

For some, that stress may be piling up on top of what was already an unsteady foundation. Parenting, particularly in the early days and particularly for mothers, is an all-consuming process. It can feel like you sacrifice much of your life only to emerge a few years later, virtually unrecognizable to yourself.

When you’ve already expended so much energy in raising your infants, it can feel like there’s nothing left to give to yourself. So, you begin making small concessions that, before long, become new habits.

Change begins not with reversing that trend, but with simply becoming aware of it. And once you start to see how easy it was to make choices that undermined your wellbeing, you’ll begin to feel empowered by the potential to shift your course.

Gaining confidence

Once a woman starts to reclaim her sense of self, she’ll become more confident, knowing she can be a mom without eliminating all other aspects of her identity. A mommy makeover, then, even for women who never previously considered plastic surgery, is a means to a fresh start, an opportunity to match her physical appearance not to the woman she remembers before she had kids but to the woman she wants to be for them.

Mommy makeover is a term that’s used to describe a combination of surgical procedures that are done in a single session. While the exact combination can be tailored to your needs and wants, it typically involves a tummy tuck, which is sometimes paired with diastasis recti repair, to tighten the abdomen and repair separated core muscles; breast augmentation, with or without a breast lift, to replace lost fullness and restore sagging breasts; and liposuction to remove excess fat and recontour the body.

Timing it right

Perhaps the biggest benefit of the mommy makeover is that, with a single surgery, you can address a range of concerns. Which means that you’re going under anesthesia only once and you’re also enduring just a single recovery.

The key is finding the right time to undergo the surgery. Every board-certified plastic surgeon will recommend that you wait until you’re done having kids. Enduring another pregnancy and labor will undo all of the surgical results. Even more, there’s no guarantee that you’ll be able to achieve the same results with a second mommy makeover at that point.

The recovery will go by faster than you think it will—most women can return to work within two to three weeks—but it’s critical that you be patient with yourself and give yourself the time and space to heal. If you have young kids, that may mean having your spouse or partner do the bulk of the parenting for a while. Even before that point, you’ll want to be in the proper headspace. It’s not so much about tempering your expectations as it is making sure you’re thinking big enough about the new phase of life that’s ahead of you.

In my last post, I highlighted the so-called “mommy makeover,” a highly customizable surgical procedure that can be a fountain of youth for women who feel like they’ve lost control of their bodies and identities after giving birth. Here, I’ll take a deeper dive, outlining what the surgery entails, how you can expect to feel in the days and weeks afterward, and where you should set your expectations for the years ahead.

What happens during the surgery

One of the biggest benefits of the mommy makeover is that, with a single surgery, you can address a range of concerns. Which means that you’re going under anesthesia only once and you’re also enduring just a single recovery.

But that also underlines the importance of, one, finding the right board-certified plastic surgeon for you and, two, being honest about your needs and wants ahead of the surgery. Because elective surgeries are generally limited to six hours as a safety measure, and the tummy tuck can absorb a significant portion of that time.

Most mommy makeovers include the following:

Tummy tuck: Your plastic surgeon will make a low, hip-to-hip incision, pull back the skin and underlying tissue, repair and tighten the ab muscles, and remove the excess skin and tissue. A hernia or diastasis recti repair may also be done in the process.

Liposuction: Fat is suctioned out through a thin tube, called a cannula, that’s inserted through small incisions at the targeted areas.

Breast augmentation: Usually coupled with a breast lift, your plastic surgeon will insert silicone implants, remove the extra skin, and reposition the nipples so that they sit higher on the breasts.

Common additions include a Brazilian butt lift, where fat that’s removed through liposuction is transferred to the butt to increase the volume and enhance the shape, and vaginal rejuvenation. Here, your plastic surgeon will perform a perineoplasty to tighten the vagina’s entrance and vaginoplasty to restore the vaginal canal and floor.

What to expect afterward

Plan to take a couple weeks off after the surgery so that you can fully dedicate yourself to healing. You’re probably going to be fairly sore for the first few days, but you’ll be prescribed pain medications that will help with much of it.

Some scarring is inevitable. But, for as invasive as the surgery is, the scars will be well-hidden—even in a bathing suit. Plus, there are number of treatments available to help reduce them once you’ve recovered, including microneedling with platelet-rich plasma and laser therapy.

You’ll start to see some of your results as the swelling subsides after a couple of weeks. Over the coming months, they’ll become even more defined. After a few months, you should see the full scope of your new figure. And those improvements will be long-lasting. As long as you maintain a healthy lifestyle, they’ll hold for years to come—even as your kids continue to make your life as difficult as they can.

When you’ve never had any kind of cosmetic plastic surgery, it’s natural to wonder what would make a woman want to put herself through a “mommy makeover”? After all, it’s an extensive surgery with a fairly uncomfortable recovery, at least in the days immediately following the surgery.

There’s no blanket answer, of course. We’re all motivated by different things at different points in our lives. Courtney, a 35-year-old fitness coach, is someone who never considered a mommy makeover—until, after two kids, she found herself consulting with a board-certified plastic surgeon.

During her first pregnancy, in 2016, she gained 75 pounds and lost 50 after giving birth. When Courtney got pregnant again a year later, she gained another 75 pounds. “I thought I’d gain a normal amount, like 20 or 30 pounds. I definitely wasn’t expecting it, but I couldn’t help it,” she writes in a recent essay for RealSelf, an online community for learning and sharing information about cosmetic surgery. “So I weighed about 235 pounds when I delivered my second kid via C-section—and that’s when I really knew I had to do something. I had all these stretch marks and was feeling like a stranger in my own body.”

Two months after the birth of her second child, Courtney, who admits she had never worked out a day in her life, began following a nutrition and exercise plan. After only a few weeks, she noticed an appreciable difference in how she looked and felt. Ultimately, she lost 100 pounds in six months—and gained a new passion in the process. By becoming a personal trainer, Courtney was able to keep flexible hours and spend more time with her two kids. It was also a means, she says, to continue to hold herself accountable.

Thrilled as she was with her weight-loss and fresh outlook, her body was still a major source of concern for her.

“I remember when I first met with my plastic surgeon after deciding on the mommy makeover. He asked what bothered me most. I just sat down and showed him my stomach, and he was like, ‘Ohh … ,’” Courtney writes. “My skin looked melted. After losing 100 pounds and becoming the strongest I’d ever been physically, it was so defeating to put on a bathing suit and have all this sagging skin. All I wanted was to feel pride in my strength and how far I’d come.

“That’s why I eventually decided to get the mommy makeover,” she says. “I think a lot of women are really scared to have a tummy tuck, but since I’d had two C-sections and the second was a pretty rough recovery, I thought, Well, it can’t get much worse than that.”

Courtney underwent a tummy tuck and breast augmentation last November, documenting her journey along the way on Instagram. “So many women reached out, saying [that a mommy makeover] is a dream for them and their motivation to keep losing weight and trying to hit their goals,” Courtney writes. “I know what it’s like to be the woman who is so uncomfortable in her skin she can’t even look in the mirror, and she’s who I speak for every day.”

Courtney says the key for her was having a determined mindset heading into her surgery. “If you’re having emotional issues, take your time and think about it,” she writes.

Four months after her mommy makeover, Courtney says she’s “so happy with my results” and that she “would absolutely recommend it to anyone with loose skin who has worked their ass off to get where they are.”

How long into the quarantine was it before impatience/boredom started to set in for you, a month? A couple of weeks? A few days? Whenever you arrived at that point, you probably felt the temptation to attempt some beauty treatments you’d normally leave to a professional. While most are fairly harmless, even when they go sideways, there are some that could result in hyperpigmentation and even scarring. These are three invasive home treatments you should leave to your board-certified plastic surgeon.

Microneedling

You probably noticed there’s no shortage of at-home microneedling rollers on Amazon. Don’t let that fool you into believing that you can safely and effectively mimic the procedure you have done at your plastic surgeon’s office. For one, those at-home rollers don’t penetrate the skin nearly as well as the medical-grade instrument that’s used by your plastic surgeon. That doesn’t mean that they can’t do any damage. It takes training and experience to know how deep to push the roller into the skin. Inconsistent pressure can lead to scarring.

Also, even though at-home rollers don’t go as deep, the skin is still being penetrated and bleeding does occur as a result. In your plastic surgeon’s exam room, it’s not a problem when that occurs because it’s a controlled, sterile environment. Chances are, your bathroom is not, which could set you up for a skin infection.

Chemical peels

Chemical peels have a bevy of benefits. By dissolving dead cells and microscopic debris on the surface of the skin, they can create smoother skin, a more even tone, and a brighter complexion. But that’s only when they’re administered by an experienced professional. Even a mild chemical peel—a peel with a concentration of 10% or less glycolic and lactic acids and no more than 2% salicylic acid—done at home carries the potential to burn the skin and cause hyperpigmentation if it’s left on for too long. And if you use them too often, you can strip the skin barrier and cause irritation.

Those with dark skin tones and preexisting skin conditions are also more prone to infection when they use any form of chemical peel.

Laser hair removal

To destroy hair follicles, at-home laser removal devices employ intense pulsed light (IPL), which isn’t technically laser energy. The critical difference is that the IPL targets the dark pigment in hair follicles to eventually destroy the follicles. For most, that simply means a long, arduous process that may still leave you wanting. But for anyone with dark skin, the devices can actually be dangerous because the IPL can target not only the dark pigment in the follicle but also pigment in the skin, which can lead to burns that can cause permanent scarring.

The takeaway: Most signs indicate that we’re nearly through the worst of this. If you’ve steered clear of the invasive home treatments to this point, don’t start now. You’ll be in good hands soon enough.

As we hold our collective breath, waiting for the stay-at-home restrictions to lift, here’s another date to keep in the back of your mind: June 20. The start of summer.

Under normal circumstances, we’d be registering for boot camps and tightening up our diets with an eye toward the stream of bathing-suit days just ahead of us. With the coronavirus complicating those plans, a little extra firepower may be in order. Enter CoolSculpting.

Why CoolSculpting, you ask? For one, it’s noninvasive, so there’s no downtime. The last thing any of us wants is to be pinned back on the sofa with a long recovery once the quarantine ends. The timeline also fits well. You can expect up to a 25 percent reduction of fat in the treated area over the weeks following your treatment. More on that to come. First, let me explain what CoolSculpting is.

How it works

CoolSculpting, you’ve probably heard of before this post. It and other noninvasive body-contouring treatments comprise one of the fastest-growing segments in cosmetic plastic surgery. Less familiar is the term cryolipolysis, which is the name of the process behind CoolSculpting.

An FDA-approved device freezes and kills fat cells in the targeted area without harming the skin, nerves, vessels, or muscles. It’s proven effective for treating the abdomen, love handles, the inner and outer thighs, upper arms, back fat, including the bulge under your bra strap, and under the butt. With a special applicator called the CoolMini, it can also be used to minimize or even eliminate altogether a double chin.

Are the results as dramatic as they are with liposuction? Not quite. But the procedure’s also a lot easier. There’s no anesthesia, incisions, or downtime. The treatment time depends on the size of the targeted area, or the number of areas being treated, but the procedure generally runs about an hour or less. Short enough to squeeze in before heading into the office or over lunch.

Is CoolSculpting right for you?

In my next post, I’ll get into what the treatment entails and how long it takes for the results to become visible. But, first, let’s figure out if CoolSculpting’s a good fit for you.

The treatment tends to be most effective when you’re within about 20 pounds of what you would consider to be your ideal weight. In other words, you’re looking for help with a couple of stubborn pockets of fat rather than a total-body makeover.

That’s not to say that you’re not a candidate if you’re trying to shed more than 20 pounds. It just may take two to three treatments to achieve the results you’re expecting. In that case, keep in mind that the treatments are generally most effective when they’re spaced about five months apart. If that’s a longer timeframe than you’re hoping for, you’re not out of luck. Ask your plastic surgeon about your alternatives.

I’ll leave you with this: CoolSculpting is not considered a treatment for loose skin or cellulite, but it’s shown an ability to visibly improve both in many instances. If you’ve been having a hard time picturing yourself at the shore this summer in a bathing suit, try now.

If you’ve heard about CoolSculpting in passing, the part that probably caught your attention was the low-maintenance nature of the treatment. Shed fat without a single incision and minimal to no downtime. If it sounds too good to be true, it’s not. To that end, here’s a closer look at what CoolSculpting is and how it works.

What happens during the treatment

The treatment itself generally takes between 30 minutes and an hour, depending on the size of the area being treated and the number of areas being treated. Some plastic surgeons have the capacity to treat two separate areas simultaneously with two machines.

You’ll either sit in a comfortable chair or lie down, again, depending on the area or areas being treated. And then a protective gel will be applied to the targeted area, followed by the CoolSculpting paddle. Your skin and fat will be suctioned into the paddle, where they’ll be lowered to a temperature of 14 degrees Fahrenheit.

The fat cells in the treated area freeze and then, ultimately, die through a process called cryolipolysis. You’ll feel a couple minutes of pressure and intense cold around the treated area before it goes numb, at which point you should be able to relax and fill the remainder of the time however you want—answering work emails, scrolling through Instagram, meditating.

Once the treatment is over, the paddle is removed. Your plastic surgeon will then massage the treated area with another device that’s meant to break up the crystals and expedite the body’s natural ability to metabolize and flush out the dead fat cells. That process will occur gradually over the next few months, your results improving as it progresses.

A recent study found that the initial treatment triggers an inflammatory response that dissipates after two to three months. A second treatment, if it’s performed within the first two months of the initial treatment, generates a stronger inflammatory response, which leads to an even greater reduction in fat.

When you can expect to see results

Everyone’s biology is a little different, which means no two people are going to excrete the dead fat cells at the exact same rate. That said, you’ll notice a difference within the first month of your treatment, and it’ll become even more dramatic after two months. By that point, the majority of your result should become apparent, though your body will continue to eliminate dead fat cells for up to six months following your treatment.

Most will see a significant change in their shape after a single treatment. That said, CoolSculpting is a cumulative process, meaning the most dramatic fat reductions occur after two to three treatments, on average. And each subsequent treatment better enables your plastic surgeon to “sculpt” the contours of the treated area because there’s a further reduction of residual fat.

Even better, the results are permanent. As long as you maintain a healthy diet and exercise regularly, you’ll make the most of your new shape for the foreseeable future.