Dr. Dean Kane Center for Cosmetic Surgery & Medi-Spa: October 2014

410-602-3322

Tuesday, October 28, 2014

I’m 52 and have hashimotos thyroid. I had Restylane 7 years ago, and would like to do it again. Would it be risky?

Question from Apex, NC : I’ve read some things and I am confused as to weather there is any risks of creating an autoimmune disease. I am in general good Health.

Dr. Dean Kane, board certified Plastic Surgeon from Baltimore Answers:

The human body is remarkable in it’s ability to guard itself against foreign bodies. In the case of Hashimoto’s Thyroiditis, it mistakenly identifies a molecule on the thyroid as foreign and attacks this organ. This can be similar to any and all allergic syndromes whether they are external such as pollen or internal such as auto-immune thyroiditis.

Restylane and similarly made HA’s (hyaluronic acid fillers) are a molecule made to be bio-identical to human skin HA and therefore this molecule would have no immunogenic reaction in the body. When Restylane and other injectibles are purified for human use, there maybe micro-impurities which stimulate a allergic style response.

The cross-reactivity of one molecule stimulating a immunogenic response to another molecule is even more rare.

I would recommend you contact your endocrinologist or rheumatologist to see if there is any cross-reactivity between these 2 molecules or any other concerns you should consider.

I anticipate the benefits will far outweigh the risks. Good luck.

I hope this was helpful! All the best!

Dr. Dean Kane

410-602-3322

Thursday, October 23, 2014

Restylane Vs. Voluma for the cheeks. Which one gives better result?

Question from Manhattan, NY: I have a appointment to add a little bit of filler to my cheek and my doctor suggested using either Restylane of Voluma. I already had Restylane in my tear throughs with great results, but was wondering the difference between the fillers for adding natural volume to the cheek area and if one will give you better results.

Dr. Dean Kane, board certified Plastic Surgeon from Baltimore Answers:

Great question! The pharmaceutical industry is producing a plethora of wrinkle rejuvenating injectibles and the FDA is approving them for use for different usages.

Restylane and Voluma are a sub-class of skin and soft-tissue injectible fillers using HA. They are made from the same molecule, hyaluronic acid, a normal constituent of the skin which reduces in quality and quantity with aging, photodamage and other medical syndromes. Including Restylane, Perlane, Juvederm Ultra, Juevederm Ultra Plus, Voluma, Belotero and many new-comers, the difference is in the linking bonds which make them thicker to inject and harder to break down by natural skin enzymes. It is this difference which makes them useful for epidermal fine lines, dermal wrinkles and skin folds. They are temporary “volumizers”, in effect “fillers” of the skin or soft tissues for the desired results and lose volume over 6-24 months depending on the amounts and quality of linking and amount of enzyme in your skin. If over-done, hyaluronidase, the same enzyme as in the skin can be used to reduce the fill.

I love Voluma, Juvederm Ultra Plus and Perlane for the fuller “apple” of the cheek and the same for the “Nike Whoosh” of the cheek bone.

Restylane is great for the “crow’s feet” lines not reduced by wrinkle reducers Botox or Dysport.

Other sub-classes of skin and soft-tissue injectibles unable to be reversed include:

Stimulants such as Sculptra which provide a slow and steady stimulation of dermal molecules such as collagen, hyluronic acid, elastin and others without volumizing. Sculptra firms the skin rather than fill.
Non-HA temporyary volumizers such as Radiesse which is made of calcium hydroxylapatite originated as a bone filler and is cosmetically used in microspheres to fill dermal lines or as volume.
Permanent fillers such as Artecoll, Artefill, silicone and others are volumizers and are not fully broken down by the body.

Each fulfills a certain niche in the quest for skin rejuvenation.

Find the most skilled, well experienced injector to guide you through the maze of these and more evolving skin rejuvenation injectibles, procedures, lasers, lights and surgery to achieve your desires.

I hope this was helpful! All the best!

Dr. Dean Kane

410-602-3322

Tuesday, October 21, 2014

Belly Fat!

Question:I had a baby 7 years ago i lost weight everywhere but the bottom of my belly. how can i get rid of it?

Dr. Dean Kane, board certified Plastic Surgeon from Baltimore Answers

Dear “Belly Fat”:

Every woman is different and after pregnancy, the skin stretches and the muscle and fascia stretch out too. You may put some visceral (organ) weight on or fat under the skin. It is best to undergo a proper evaluation with a Board Certified Plastic Surgeon and consider your options.

These include:

1. a traditional tummy tuck where the ab muscles are tightened, the sides are liposuction contoured, the excess skin is removed, the mons lifted and a new belly button is created.

2. a mini-tummy tuck where the skin below the belly button is removed and mons lifted.

3. a panniculectomy / lipo-sculpting where the large lower roll of tummy skin is removed and the upper tummy and sides and / or back are reduced with liposuction.

4. a body lift used with patients who have super-skin excess and the tummy, sides and back skin are lifted with or without muscle tightening.

5. liposuction of the circumfirential trunk for body contouring.

6. liposuction of partial areas such as the front abdomen with and without muscle etching, love handles, inner and outer thighs, arms, neck; any of which use traditional, syringe and ultrasonic liposculpting.

7. Cool Sculpting is a non-surgical option of multiple spot fat reductions without anesthesia.

As you can see, there are many options dependent on your desires, future for more pregnancy, budget and recovery time.

I hope this was helpful! All the best!

Dr. Dean Kane

Thursday, October 16, 2014

How should I care for behind ear incisions after face and neck lift? They feel itchy and irritated.

Question from Florida, NY

Just a little over two weeks post opt, very itchy and irritated feeling? Using perioxide and antibiotic ointment 2 times a day.

Dr. Dean Kane, board certified Plastic Surgeon from Baltimore Answers

2 weeks after a facelift incision, the dynamic changes of healing call for inflammation. This maybe the reason for the itchiness and irritation. It could also be a developing infection. Please see your surgeon to evaluate and make his recommendations.

I hope this was helpful! All the best!

Dr. Dean Kane

Tuesday, October 14, 2014

I’m so scared of the side effects I got from botox, can I die? Please help! I had 4 units above the lip.

Question from New Sweden, ME: 2 days after, as I felt the Botox over lip, I felt something in my throat, and difficulty swallowing. Next day my tonsil under the jaw was swollen. Head itching. Hives on legs. Pain in ears. Later hives on arms, face, body and felt like my face would burn up. Numbness and sensations in the face, lips, tongue, throat, legs and arms. 18 days later it’s on going. I’m so afraid! Can I die? Can the botox be spreading and develop to botulism? Can I get an allergic chock? What to do? Use antihistamine.

Dr. Dean Kane, board certified Plastic Surgeon from Baltimore Answers

Botox and other like muscle relaxers are a pharmacological grade purified protein made from the fermentation of the bacteria clostridium. There are 7 different types but only 2 are used for cosmetic and therapeutic purposes. There has been no reports of the small cosmetic doses of these medications traveling to areas farther than injected causing the symptoms or concerns of botulism. In fact, Botox, Dysport, Xeomin and Myobloc, are used 1000’s of times daily around the world.

Botulism is the growth of live bacteria in the body producing and dispersing this molecule within hours of eating it. It is found in soil and water and can occur by a using a contaminated “street” injection, consuming improperly prepared food or getting it into a wound. Onset is within hours so this is certainly not your case.

Many drugs are now made in similar fashion by fermentation and purification including antibiotics, antibodies and other life-saving uses from bacteria and fungus. The purified protein may be a cause for allergy formation from prior or serial exposure of this drug. Like the rare side-effects of Botox, flu-like symptoms and swelling or redness can occur. This sound more like your description and may or may not have been caused by a flu or Botox.

It is best to be evaluated and treated by your primary care physician or seen in the Emergency Department of a hospital if the symptoms and concerns are progressing. If there is concern that this maybe an allergy related to the Botox molecule, you may be sent to a allergist to diagnose this.

I hope this was helpful! All the best!

Dr. Dean Kane

Thursday, October 9, 2014

I’m 22 year old and looking at Botox/Dysport. Is this too young?

Question from Sydney, AU

What age is it typically recommended to get Botox injections? I’m 22 and I’m starting to notice fine lines.. By no way are they very noticeable but I know Botox is preventable. Is it also true that the injections can work as a brow lift? Because I have very slightly hooded eyes and I would love it if these lifted the forehead area up a bit..

Dr. Dean Kane, board certified Plastic Surgeon from Baltimore Answers

Botox has both therapeutic and cosmetic applications. It is used functionally in young children with various spastic muscle and many other problems. For cosmetic uses in relaxing the muscles of facial expression before deeper and more permanent lines set in, Botox is never to early. This will help along with properly used retinoids to prevent lines, wrinkles, folds, pigmentation and aging skin. Please seek the advice of a well experienced, board certified plastic surgeon or other expert injector and skin specialist for a review of your best options.

I hope this was helpful! All the best!

Dr. Dean Kane