Dr. Dean Kane Center for Cosmetic Surgery & Medi-Spa: February 2015

Saturday, February 28, 2015

Could Restylane Silk lip injection cause permanent bumps/nodules?

Dr. Dean Kane Q & A.

Q. Could Restylane Silk lip injection cause permanent bumps/nodules?I just had a small amount (maybe 1/4 of the syringe left from Nasolabial folds ) of Restylane Silk injected in my lips 2 days ago by a certified plastic surgeon . My upper lip was moderately swollen and lower lip bruised in the corners. I feel some bumps/nodules, some of them are visible . My question is if this is normal for this product, and should I be concerned that it's going to be permanent? And what if anything should I be doing or applying?

A. Restylane Silk is a new product to the US. It has been used extensively in Canada, Europe and elsewhere. It is very injector dependent! Ie., the skill level for Silk is not as easy as other gel fillers.

While it is a hyaluronic acid (HA) injectible similar in its molecular structure to the well known Restylane, Perlane and Juvederm family, it has different characteristics. "Silk" is extremely hydrophyllic or water-loving due to lesser number of links between HA molecules. Attracting more water means it will expand to a greater degree with less volume of the gel.

It should be used sparingly in any particular location and maybe compressed or massaged should there be a bump or irregularity. Like all HA's, it will be dissolved by the body's natural hyaluronidase, an enzyme which your injector may have for such concerns.

HA's do not create a foreign body inflammatory response, so the likelihood or permanence is unexpected.

Thanks for sharing your photo. There appears to be some irregularity along the "cupid's bow" vermilion white line. This may be due to bruising.

Discuss your concerns with your injector and the options for improvement.

I wish you the best!

I'm considering CoolSculpting for my arms as they have become saggy. Could it make them worse?

Dr. Dean Kane Q & A.

Q. I'm considering CoolSculpting for my arms as they have become saggy. Could it make them worse?

A. CoolSculpting is a "tried and true" method to reduce fat content in skin bulges!

It has worked very well on properly selected patients for the arms. In fact, even heavy patients have been pleased because the small increments of arm fat reduction allows them to wear tops with sleeves that have previously been tight.

Thinner patients are pleased with CS's results on their arms as well. Caveat emptor: do not expect skin reduction or tightening with CS! On occasion, patients, particularly of color or reddish coloration have experienced some skin shrinking. This is due to the inflammatory response which is seen more in these patients, than those of white, north european descent.

You should discuss CS as well as other options such as lipocontouring and / or arm lift with a well experienced, board certified Plastic Surgeon who has properly examined you.

I hope this is helpful!

All the best!

My smile has completely changed after Botox on forehead, frown lines, crows feet, & under eyes. Any suggestions?

Dr. Dean Kane Q & A.

Q. My top lip doesn't lift enough. When smiling with lips together it looks normal but when smiling or laughing with lips apart my top lip isn't lifting so looks like half a smile. My injectant didn't inject low down on crows feet but could it still have an effect on my smile muscles?

A. Botox is a miraculous drug when used correctly. It is extremely artful and injector dependent on his or her skills.

Thank you for sharing your photos. When Botox or any of the muscle relaxer injectibles is not specifically targeted, adjacent muscles may be affected causing relaxation and therefore an imbalance on facial appearance. It appears that the muscles of your eyelids, your right lower lip and your cheeks received a dose of Botox during your injection session causing your eyelids and upper lip to drop and your right lower lip to raise.

The good news is that if minor amounts of Botox reached these muscles, the waiting time for the muscles to return to normal function is shorter than the average 3 months. It will also return to full function.

You may consider discussing the eyelid droop with an ophthalmologist as there is a eye drop than can help if seeing is a problem. You may also consider widening the area of placing your lipstick to camouflage the reduction in lip opening.

If you have concerns with your injector, consider another opinion by a well experienced, Board Certified Plastic Surgeon or ENT Facial Surgery injector to review these problems.

I wish you the best!

Am I a good candidate for restylane? Do I have under eye hollowing?

Dr. Dean Kane Q & A.

Q. I'm very un shutterstock_16773217

happy with the way my under eye looks. Would I need more than one syringe? I've been saving up for a while, so far I have saved $700. I am looking for a skilled surgeon in the New York City area because I live in Brooklyn, but the search is so over whelming at times. Any advice, (PLEASE!!!!!) would be greatly appreciated.

A. The fold under the eye is due to complex changes occurring during aging. These include:

reduction in the fat volume,
separation and descent of the distinct packets of fat in the eyelid and cheek,
laxity and elongation of the cheek and jowl skin and underlying tissues,
and other changes.

It is best to be evaluated by a well experienced, Board Certified, Plastic Surgeon or ENT Facial injector to identify what is best for you. Injectibles are very injector dependent upon their knowledge of anatomy and skill level. Choose wisely.

Thank you for sharing your photos. You may achieve the results you are looking for with fillers but it will require more than one cc (syringe) of gel filler. You may wish to consider other options.

As you have inquired on Real Self, you may wish to review other responses to lead you to a qualified injector in your area.

I wish you the best!

Will lymph drainage massage help after a Facelift?

Dr. Dean Kane Q & A.

Q. I have heard a Lymphatic Massage helps against swelling after a FL. Is this true or just performed because of the placebo effect? It is quite expensive and the Danish doctor says at least 5 treatments are needed? Is there any research proving this?

A. It is a natural and expected side-effect following surgery or injury to develop swelling and scar. If fact, this is how the body heals itself. In some patients, the swelling may be quite uncomfortable and compromise the result of the surgery.

I, too, recommend massage following surgery but it must be performed by you with proper instruction or a well trained individual who understands the post-surgical and healing process.

The warmth of your hands improves circulation, the pressure placed and the technique of massage applied changes during the process of healing. I have developed and recommend 3 basic techniques and variations:

Swedish massage: light moisturizing or gentle washing - like upward touching of the skin. This will assist in sensitizing or de-sensitizing the skin as the sensation returns. It is very useful for individuals who are reluctant to touch the surgical site as well.

Lymphatic, "squeegee" massage: firmer compression or moving pressure pushing a wave of fluid out of the swollen area of surgery or injury. It is likened to squeezing water out of a sponge. Studies have shown that retained swelling or edema creates a cycle of lymphatic obstruction and persistent swelling. Retained swelling over many months also creates more lumpy scarring and collagen bundles. Lymphatic swelling, I believe, will assist in remodeling collagen in the direction to best match your facial contour, so massage firm but gently always in an upward direction.

Shiatsu, deep pressure or deep scar massage: directed deeper accentuated pressure with a rolling or rocking character to break up the lumpy collagen scar formation. Such lumpy scar, if it forms, does not occur for 3-4 weeks after surgery so do not use this technique unless your surgeon directs you too. It is followed by long strokes of lymphatic massage.

I recommend these techniques 3 to 5 times a day for very short periods of time.

Lymphatic and Shiatsu massage may also create different levels of trauma to the tissues or break sutures placed specifically to suspend or hold tissues in place.

More IS NOT better.

DO NOT perform such therapy without the specific instructions of your surgeon. If deep scarring or reduced function occur, your surgeon may recommend physical therapy for other alternative techniques and ultrasound therapy.

Higher protein, low carbohydrate diets also assist in healing and swelling reduction due to the hormones this dietary balance generates in the body.

Most importantly, consult your surgeon regarding the use of these or other techniques in assisting your healing following facelift or any other surgery or injury.

I hope this has helped.

All the best!

Monday, February 9, 2015

I'd like to improve my eye area upper and lower. Would fillers and/or Botox would be a good combination?

Dr. Dean Kane Q & A

Q. I'd like to improve the look of my eyes without a large expense. I'd like to get rid of the bags and wrinkles under my eyes, the crows feet and my frown lines.

A. I will answer your request in a very comprehensive way. As you point out, cost and maybe recovery time are an issue and this may determine your satisfaction for the goals you set and expectations you have.

Thanks for sharing you photo. This is helpful but you will need a in-person consultation to examine you and review your options.

Various options for facelifting, minimally and non-invasive facial enhancements and skin texture improvements are available according to the skin laxity and areas of lift or tightening you wish or need. Both surgical and minimally invasive / non-surgical options are listed below.

Surgical lifts would be likened to pulling the bedspread and or top-sheet of your bed up to the head-board and removing the excess material.

Minimally invasive procedures such as fillers provide volume such as adjusting a pillow under the bedspread. Botox and Dysport act by pulling the top-sheet which drags the bedspread upwardly. If the bedspread (or skin) continues to fall to the foot of the bed despite fillers, Botox or Dysport you will need to consider a facelift.

Non-invasive options such as laser and light therapies, skin tightening products and technologies perform their tightening and smoothening of the skin similar to sending your bedspread to the dry cleaners. A more refreshed, even colored, glowing smoother and tighter spread covers the surface of the bed.

The most popular of the fillers, Restylane and Perlane, a jelly-like clear skin filler is used to fill lines, wrinkles and folds. Juvederm and its longer lasting "cousin" Juvederm Ultra Plus are similar skin fillers, used to soften and fill the nasolabial ("parentheses") and marionette folds, the brow ("number 11") lines and fill and lift the cheeks and lateral brow or chin. Voluma is the longest lasting, up to 2 year duration HA filler. Each one is used to expand or volumize the loss of tissue associated with expression, weathering or aging. All the fillers come with numbing anesthetic!.

Non-surgical facial contouring is possible with fillers such as Radiesse, a bone mineral for the nose or cheeks, jaw and chin as well.

Scuptra is the latest of the injectibles stimulating collagen at different levels of the skin adding volume but primarily firming and adding resistance to the formation of wrinkles, folds and descent.

Botox and Dysport too have been found to rebalance excessive facial expression, provide a non-surgical brow lift and lip lift and reshape the nose, as well as reducing wrinkles!

Your photo does show significant dry skin, loss of elasticity, folds and wrinkles.

Dr. Obagi's new, second generation ZO Skin Health programs may be added to personalized chemical peels, light and laser resurfacing and tightening and will, smoothen and even the color of your skin. It is the basis for all skin rejuvenation in our practice.

IPL and fractionated lasers such as CO2 and erbium and now RF (radiofrequency) are additions to smooth the texture of the skin, tighten and reduce red and brown uneven pigmentation.

If you can pinch more than an inch of skin along the jawline in front of your earlobe, you should consider a surgical option to redrape and remove extra skin.

You may consider: a traditional face and neck lift, short scar face and / or neck lift.

The recent resurgence of the S-Lift (created in the early 1900's), also called by other names as the Quick-Lift, Lifestyle-Lift, Swift-Lift, Soft-Lift, MACS-Lift and others; are a single modification of the S-lift targeted to elevate sagging lower cheeks jowls and lateral upper neck. The shorter scar, limited undermining and second layer lift achieve the "quicker" procedure but not necessarily the quicker recovery or the improvement you desire.

Face lift and / or neck lift or any of the other procedures and their combinations should be discussed following a proper examination by a Board Certified Plastic Surgeon who performs all of these options so you will not receive a biased approach because he or she is limited in their skills.

I hope this was helpful!

Do chronic diseases such as kidney and lung disease rule you out as a candidate for a face lift? How about breast augmentation?

Dr. Dean Kane Q & A

Q. Do chronic diseases such as kidney and lung disease rule you out as a candidate for a face lift? How about breast augmentation?

A. With spectacular medical innovations and new drugs, increasing numbers of people are living with chronic diseases who have may have had shorter lives years ago.

Surgical techniques and devices have improved and are available for medically optimized individuals.

Surgery and procedures which require local, sedation and general anesthetics offer a safe positive experience for the majority of elective cosmetic procedures.

There are many considerations, costs, recovery time and other factors to review. There are many, many patients who proceed with positively reaching their desires and goals.

A well experienced Board Certified Plastic Surgeon and your Primary Care Physician must evaluate you, optimize your medical condition(s) and if the risk / benefit ratio is reasonable proceed recognizing this DOES NOT mean no risk.

I hope this was helpful.

All the best!

Sunday, February 8, 2015

Can Derma Pen or Botox fix these little lines under one eye?

Dr. Dean Kane Q & A

Q. I'm about to turn 26 in June. My skin is in really good condition as I've been vigilant about skincare since my teens (including staying out of the sun, SPF etc..) The past year however, I noticed a small patch of lines form under my left eye. I have spent quite a bit of money on under eye treatments & creams & they haven't diminished at all, but they haven't gotten worse either. Could these have been caused by sleeping on my left side? My right eye doesn't have the same lines. Thank You :)

A. Congratulations on maintaining your youth!

As we age, there is passive loss of elasticity and hydration of the skin. It no longer shrinks back but begins to crease. The inability of your skin to make more elastin, collagen, hyaluronic acid and other rejuvenating skin molecules leads to the skins aging. Weather, UV, tobacco all contribute too.

At 25, you have the beginning of a rounding lower eyelid. Botox will relax the muscles which add to crinkles in the eyelid but also to drooping of the lower lid and puffiness of the eyebags. I don't believe this is for you.

Derma pen or micro-needling of the eyelid is an option to stimulate the repair and rebuilding mechanism to reverse loss of these molecules but is risky next to the eye.

Please consult with a well experienced Board Certified Plastic Surgeon, Ophthalmologist (one World Renown one in your town) or Dermatologist (also World Renown an spouse of the latter on Vancouver) to review your options to REJVENATE such as:

1. Retin-A, Retinol therapy,
2. Fillers,
3. Peels and Laser
And others.

I hope this has been helpful! All the best.

Dean Kane, MD

Botox doesn’t work anymore! Is there a way to make it work again?

Dr. Dean Kane Q & A

Q. I have been getting botox, Dysport an Xeomin injections for years and now none of them work! I get a small effect but it does not last long. The procedure has been done by several different clinicians so I don't think it is the way it is done. I think I have built up a resistance. I love the effect when it works. Is there any new formulas or way to make it work again?

A. I hear this about once a day. While it is possible that Antibodies to the molecule reduce its effectiveness, I have yet to see this following 1000's of patient injections.

With careful observation, a well experienced, Board Certified Plastic Surgeon, Facial ENT, or Dermatologist will find that:

1. The muscles previously injected have atrophied to a point of not working. You will find that injections to other muscles will relax them. You will need a more skilled injector.

2. With aging, the laxity of the tissues and the attachments of the frontalis (and other) muscles to the skin, release and slide. Greater pull or relaxation using these muscle balancers will not produce the same effects. You will need to consider a surgical option.

Consider a 2nd opinion in-person consultation.

I hope this has helped.
All the best.

Wednesday, February 4, 2015

Which would you recommend; PDO Thread Lift or Dermaroller to address fine lines and mild sagging in lower face?

Dr. Dean Kane Q & A.

Q. I have a slight downward turn at the corners of my mouth and vertical fine lines that appear indented just below the corners of my mouth, either side of my chin. The right side of my face is worse, as this is the side I sleep on. Do you think a PDO Thread Lift or Dermaroller would best address this problem? I know the PDO threads only last up to 2 yrs. FYI i do have naso-labial folds which I think can be resolved with filler but this wouldn't address the lines or downward corners of my mouth.

A. Both a ThreadLift and Dermaroller address different aspects of facial aging. Without a in-person consultation, these may not be my first choices depending on your skin laxity, lack of fullness skin texture and ethnicity among many other variables.

Various options for surgical facelifting, minimally and non-invasive facial enhancements and skin texture improvements are available according to the skin laxity and areas of lift or tightening you wish or need. Both surgical and minimally invasive / non-surgical options are listed below.

Surgical lifts would be likened to pulling the bedspread and or top-sheet of your bed up to the head-board and removing the excess material.

Volumais the longest lasting, up to 2 year duration HA filler. Each one is used to expand or volumize the loss of tissue associated with expression, weathering or aging. All the fillers come with numbing anesthetic!

Non-surgical facial contouring is possible with fillers such asRadiesse, a bone mineral for the nose or cheeks, jaw and chin as well.

Sculptra is the latest of the injectibles stimulation collagen at different levels of the skin adding volume but primarily firming and adding resistance to the formation of wrinkles, folds and descent.

Botox and Dysport too have been found to rebalance excessive facial expression, provide a non-surgical brow lift and lip lift and reshape the nose, as well as reducing wrinkles!

Dr. Obagi's new, second generation ZO Skin Health programs may be added to personalized chemical peels, light and laser resurfacing and tightening and will, smoothen and even the color of your skin.

IPL and fractionated lasers such as CO2 and erbium and now RF (radio frequency) are additions to smooth the texture of the skin, tighten and reduce red and brown uneven pigmentation.

If you can pinch more than an inch of skin along the jawline in front of your earlobe, you should consider a surgical option to redrape and remove extra skin.

You may consider: a traditional face and neck lift, short scar face and / or neck lift and ThreadLift.

Sincerely,

Dean Kane, MD, FACS

What is a Mini Mommy Makeover?

Dr. Dean Kane Q & A.

Q. How is it different from a regular mommy makeover?

A. I have not heard of a Mini, Mommy Makeover.

Known by many as a "Mommy Make-over", the decision making involves a variety of different procedures alone or in combination for women following childbirth, massive weightloss and menopause. The breast and the tummy lose tone and while the volume of the breast diminishes and sags, the tummy muscles and are stretched and loosened.

There are various options are for tummy or trunk, arms and leg contouring.

These options are dependent on your skin laxity and the areas of liposuction contouring you wish or need.

You can consider:

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. A similar technique is used for the upper arms called brachioplasty or thighs called thigh-plasty.

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. Please consider the newest non-surgical, non-invasive technique to reduce body fat bulges and rolls!

CoolSculpting is tried and true for focused areas of fat thinning such as:

Tummy pooch and love-handles

Breast rolls and back rolls

Man-breasts

Inner thigh and under the butt "banana-roll"

Outer thigh and arms

Other areas patients have used CoolSculpting are:

The bulge adjacent to a scar,

Tightness around the arm, waist or thighs in clothing, and

Residual fullness after liposuction or tummy tuck.

The different breast lift / augmentation and reduction options depending on your needs:

1. a crescent lift to raise the areola

2. a donut lift will raise the areola, make it smaller and partially lift the breast

3. a vertical lift or mastopexy is used to further lift the breast as well as make the areola smaller

4. a traditional or "T" lift is necessary in larger women with more loss of volume to lift the breast

5. Any of these lifts can and are combined with a breast enlargement if desired using saline (salt water) or silicone gel implants

6. Some patients may wish to improve the contour along the side breast roll with liposuction

7. Breast reduction

A lot to consider! I recommend you obtain the evaluation and recommendations of a well seasoned and Board Certified Plastic Surgeon in consultation.

Good luck!

I'm skinny, am I a candidate for a Tummy Tuck? And also should I get a Breast Implant or lift?

Dr. Dean Kane Q & A.

Q. I'm 37 years old, I had my first son when I was 19, since then I have Had lots of stretchmarks in my tummy, I'm very skinny and I always been fit... So I learned to live with it, people used to tell me I'm too skinny to get a tummy tuck... But Im ready now to do something about it, I want to be able to wear bikini... I'm 93 lbs and 5'1. Should I get a mini tummy tuck? A full tummy tuck? Or should I consider other options like laser.

A. Pregnancy certainly can create havoc with a woman's body! Despite some stretch marks, you appear to have fared well.

There are various options are for tummy or trunk, arms and leg contouring.

These options are dependent on your skin laxity and the areas of liposuction contouring you wish or need.

You can consider:

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.

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.

7. Please consider the newest non-surgical, non-invasive technique to reduce body fat bulges and rolls!

CoolSculpting is tried and true for focused areas of fat thinning such as:

Tummy pooch and love-handles

Breast rolls and back rolls

Man-breasts

Inner thigh and under the butt "banana-roll"

Outer thigh and arms

Other areas patients have used CoolSculpting are:

The bulge adjacent to a scar,

Tightness around the arm, waist or thighs in clothing, and

Residual fullness after liposuction or tummy tuck.

I am not a fan of laser or skin tightening. The results are miserable and not long lasting.

The different breast lift / augmentation and reduction options depending on your needs:

1. a crescent lift to raise the areola

2. a donut lift will raise the areola, make it smaller and partially lift the breast

3. a vertical lift or mastopexy is used to further lift the breast as well as make the areola smaller

4. a traditional or "T" lift is necessary in larger women with more loss of volume to lift the breast

5. Any of these lifts can and are combined with a breast enlargement if desired using saline (salt water) or silicone gel implants

6. Some patients may wish to improve the contour along the side breast roll with liposuction

7. Breast reduction

While all of this is not specific to you, it is a lot to consider! I recommend you obtain the evaluation and recommendations of a well seasoned and Board Certified Plastic Surgeon in consultation.

Good luck!

Should I Stop Supplements?

Dr. Dean Kane Q & A.

Q. Should I stop taking any of the following OTC supplements before my "Mommy Makeover" on Feb 5th? My PS has not indicated that I should, but I also forgot to ask during our consultation. Women's Multi-vitamin? Pro-biotics? Colace? Thank you for your response.

A. Supplements may optimize your metabolism but can interfere with your healing. Supplements may inhibit or augment the medications you have been prescribed.

It is essential to discuss your medications AND supplement use with your surgeon as it can affect your outcome, side-effects and risk and complications of the procedure you are about to "invest" in!

For example:

St. Johns Wort, Yohimbe and Licorice root many inhibit the activity of your MAO and SSR Inhibitors.

5 Hydroxy Tryptophan; Valerian; Kava and Melatonin may increase GABA & Serotonin stimulation causing greater sedation.

Arnica; Bromelain; Black Mushrooms; Clove oil; Gingko biloba; Ginseng,Ginger; Garlic, Bilberry; Dong Quai; and Feverfew may add to the anti-coagulant effects of Vitamin E; Honeysuckle; Wintergreen; Aspirin; Ibuprofen; Naprosyn;

Chondroitin/Glucosamine; Saw Palmetto; Fish Oil / Essential Fatty Acids; Co-Q-10 and other NSAIDS.

Phentermine; Ma Huang; MetaboLife; MetaBoost; Ephedra and other Weightloss Supplements may cause unstable blood pressure or elevated and irregular heart rate if used with other medical stimulants at surgery.

Echinacea; Goldenseal and Milk Thistle may potentiate liver dysfunction, immunosuppression and potentiate the effects of anesthesia medications.

These are just a few of the concerns your physician and surgeon have in your welfare. Please fully discuss the use of your supplements, diet, drinks and medications with your caregiver prior to your surgery!

All the best!

I had a baby 40 days back. I am back to my normal weight before pregnancy and considering a vaser lipo . Do I need to wait for 6 months since I didn't gain any weight? I am just wanting to get rid of the excess weight in my lower abdominal since I had C-section.

Dr. Dean Kane Q & A.

Q. I had a baby 40 days back. I am back to my normal weight before pregnancy and considering a vaser lipo . Do I need to wait for 6 months since I didn't gain any weight? I am just wanting to get rid of the excess weight in my lower abdominal since I had C-section.

A. Known by many as a "Mommy Make-over", the decision making involves a variety of different procedures alone or in combination for women following childbirth. The breast and the tummy lose tone and while the volume of the breast diminishes and sags, the tummy muscles and are stretched and loosened.

Below is a fairly detailed list of the procedures based on your needs or desires.

These options are dependent on your skin laxity and the areas of liposuction contouring you wish or need.

We can consider:

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.
a mini-tummy tuck where the skin below the belly button is removed and mons lifted.
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. A similar technique is used for the upper arms called brachioplasty or thighs called thigh-plasty.
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.
liposuction of the circumfirential trunk for body contouring.
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.
Please consider the newest non-surgical, non-invasive technique to reduce body fat bulges and rolls!

CoolSculpting is tried and true for focused areas of fat thinning such as:

Tummy pooch and love-handles

Breast rolls and back rolls

C-Section bulge

Inner thigh and under the butt "banana-roll"

Outer thigh and arms

Other areas patients have used CoolSculpting are:

The bulge adjacent to a scar,

Tightness around the arm, waist or thighs in clothing, and

Residual fullness after liposuction or tummy tuck.

It is best for you to consult with a well experienced, Board Certified Plastic Surgeon to evaluate your concerns and discuss your options.

All the best!

Dean Kane, MD, FACS

I am going in for a rhinoplasty, surgeon stated takes 5 seconds to crush them. if no issue, take them out or keep?

Dr. Dean Kane Q & A.

Q. I am going in for a rhinoplasty, surgeon stated takes 5 seconds to crush them. If no issue, take them out or keep?

A. The turbinates are a very functional feature of the nose. Typically there are 4 turbinates along the outer side of the inner nose and they provide:

1. hydration to the air we breath
2. mucous to catch dust and any particles traveling toward the lungs
3. heat the air
4. provide a first defense in capturing bacteria and viruses.

They don’t seem so useful when they are congested or enlarged obstructing the ability to breath. At times when swollen they obstruct the sinuses causing pain and infection.

Unless you have very severe symptoms from turbinate hypertrophy, I recommend injecting the turbinates with a steroid and fracturing it outwardly. This will increase the space available to breath by shrinking the turbinate size and angle the turbinate outward while keeping it available for its useful functions.

Removal of the turbinate should be used in only extreme cases due to the risk of complications including:

1. bleeding,
2. crusting,
3. malodorous smells,
4. dryness of air and others.

Please seek a well experienced and Board Certified Plastic Surgeon or ENT surgeon for evaluation and recommendations.

All the best!

Dean Kane, MD, FACS

I'm having an age spots frozen and then a face lift. How long in between each treatment?

Dr. Dean Kane Q & A.

Q. I am having some age spots frozen/ from my face then 3 weeks later have a neck and lower face lift. Is that enough time between the treatments

A. Congratulations for taking the leap to personal rejuvenation.

Age spots can be different things to different people and providers. They are pigmented lesions seen mostly in lighter skinned but very sun exposed patients. They maybe lentigos created from the melanocyte or melanin forming cells or a seborrheic keratosis formed from the top layer cells in the skin.

They maybe removed in a variety of ways including:

1. liquid nitrogen freezing
2. cautery or dessication with a “electric pencil”
3. laser
4. chemical peel.
While superficial, they should fully heal so the injury to the underlying skin does not affect circulation or provide a break in the defense of the skin when the face and neck lift are performed.

I would recommend no less than 3 weeks between dessication of a skin lesion directly on the area of the face and neck lift.

I hope this is helpful! I wish you the very best!

What's a good filler may I use for scar in forehead?

Dr. Dean Kane Q & A.

Q. I got full forehead scars I tried juavederm ultra but didn't get good reasult but better than before. May I use sculptra?? It really bothers me.

A. Every scar is different. Each person and each body or face site that the skin is cut or punctured will heal with a different quality of scar.

Some are flat and thin but many are thick and ropey, red or pigmented brown.

Some pull causing a contracture or are lumpy. There are many different treatments depending on the quality of your scar(s) which I will address below.

When it bothers you as it does, you may consider the following options:

1. Waiting for the scar to “mature” i.e. become soft and flat

2. Massaging the scar, using scar creams and silicone sheeting to soften it

3. IPL and vascular laser and light therapies to reduce the redness and ‘ropeyness’

4. Steroid injection to reduce the growth and lumpiness

5. Retinoids, hydroquinone skin therapy to reduce the thickness and pigmentation

6. Surgical removal and revision of the scar.

7. Fillers to fill the loss of tissue under the scar and make it smoother.

8. Microdermabrasion or Dermabrasion to reduce the raised surfaces making the scar smoother.

9. Micro-needling to restart the inflammatory phase of healing in the hopes of remodeling the scar and re-epithelializing the surface.

10. Sculptra injection to remodel the scar and fill the depression. This, like any technique is very skill dependent.

A scar is permanent and many times becomes imperceptible. Time, of course will help scars improve.

You can appreciate the many ways to help your scar.

I recommend you consult with various well experienced and Board Certified Plastic Surgeon, ENT or Dermatologist to evaluate and provide you with their recommendations.