Could I be a Restylane Candidate?

Dr. Dean Kane Q & A.

Q. I am so over these eye bags. I'm only 30, but I feel 100! Help! Should I get Restylane fillers, or should I go with a lower blepharoplasty? Thanks.

A. Thanks for sharing your photos. ​Yes, Restylane is an alternative to mask the bags by elevating the folds. It takes special skills so choose your injector wisely.

​It would also be important to have your thyroid hormone levels checked and a proper evaluation of your eyes, lids and boney structure. Eyelid surgery is a possibility but in your photos, I detect some eye bulging and asymmetry. This may indicate an overactive thyroid gland or other anatomic concerns regarding your options.
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​Consult with a well experienced and Board Certified Plastic Surgeon, OculoPlastic Surgeon and  / or Facial ENT Surgeon who perform eyelid surgery regularly.
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​I hope this is helpful. All the best!

Would cool sculpting work for me with 2 treatments? Or is Liposuction necessary?

Dr. Dean Kane Q & A.

Q.  Would cool sculpting work for me with 2 treatments? Or is Liposuction necessary? I am 37 years old and have stubborn arm fat which hasn't been improved with any type of exercise or diet all my life. Otherwise I am happy with my body. I am also nervous about the after effects of lipo. I have read many people saying that years after lipo their metabolism seems to shift and they start gaining weight uncontrollably in weird places. I have maintained a weight with 7 lbs of fluctuation through the last 15 years.

A.  ​​​Thanks for sharing your photos. Although they are limited, you seem thin with mild lipodystrophy (fat) and skin laxity of the upper arms. I can appreciate your frustration!

​It is best to obtain consultation from a well experienced, Board Certified Plastic Surgeon with all skills for a upper arm contouring and lift so you are not biased by their lack of options.
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​Please consider the following:

1. ​CoolSculpting 1 or 2 sessions per arm to reduce the superficial fat and possibly (although no guarantees!) obtain some skin shrinkage around the smaller volume. This is very limited to the areas bulging only.
2. ​LipoContouring which will provide near circumfirential fat reduction and etching of the upper arm muscles. You may obtain some skin shrinkage around the smaller volume but also skin redraping due to the wider contouring.
3. ​A arm(pit) tuck may help in advancing the skin and reducing the skin excess. This option may be performed at the same time as lipocontouring but in your case due to age and exercise may be best 6-12 months later after the lipocontouring has healed and softened. It limits the scar to the armpit but also limits the amount of skin reduction.
4. ​A brachioplasty (arm lift). This incision comes down the inner aspect or back or the arm to remove skin excess but leaves a more visible scar. I would also recommend to do this a year later after lipocontouring.

I hope this has been helpful!

All the best!

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What surgery what you recommend to fix my face, teeth and jaw?

Dr. Dean Kane Q & A.

Q.  What surgery what you recommend to fix my face, teeth and jaw? I have been interested in surgery for a while now and curious to what surgeries that would help my face look better, example my jaw, chin, nose and teeth?

A.  ​Thanks for sharing your photos. You appear young and pretty with teeth and possible jaw and bite irregularities.

Please explore your community for a multi-talented, well experienced and Board Certified Plastic Surgeon, ENT Facial Surgeon or Oral MaxilloFacial Surgeon to review your “orthognathic” concerns, perform a proper examination and make his or her recommendations.

A proper exam will include XRays or CT scan of the face to determine proper upper and lower jaw alignment, cheek and chin shape. It appears that your front teeth do not allow your jaw to fully close and this will also require the expertise of a orthodontist to work with your facial surgeon. Your facial surgeon will also address your nose, chin and cheeks regarding changes to shape with and without your surgical or non-surgical options.

​I wish you luck with this endeavor!

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.

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​Surgical techniques and devices have improved and are available for medically optimized individuals.
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​Surgery and procedures which require local, sedation and general anesthetics offer a safe positive experience for the majority of elective cosmetic procedures.
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​​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.
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​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.
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​I hope this was helpful.
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​All the best!

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.

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​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.

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!

Dr. Dean Kane Q&A – Hello! Do I need a facelift or a mini facelift? Thank you

Question from Toronto, ON: I am thinking about a Face lift but I am confused after reading so much about Facelifts. Please give me your opinion. Thank you very much.

 Answer from Dr. Dean Kane, Board Certified Plastic Surgeon from Baltimore:

​You appear to have a fuller and tighter face than the usual individual requesting a face lift. You also appear to have a fuller side and a flatter side which is found in almost all patients. 
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​Both a "Face Lift" and a "mini Face Lift" primarily redrape the skin in a upward and outward direction, followed by removing skin excess and then sewing the edges together. Based on your photos, I do not believe this will significantly help you. 

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 thefillers,RestylaneandPerlane, a jelly-like clear skin filler is used to fill lines, wrinkles and folds. Juvederm and its longer lasting "cousin"Juvederm Ultra Plusare 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.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!.

Scuptrais 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.

BotoxandDysporttoo 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 generationZO Skin Healthprograms may be added to personalized chemical peels, light and laser resurfacing and tightening and will, smoothen and even the color of your skin.

IPLand fractionatedlaserssuch asCO2 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. 
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​Returning to your concerns, it appears that lipo-contouring the lower cheek / jowl / neck,  fillers, Sculptra and proper skin healthcare with retinoids may be best options for you. 

Face and neck enhancements 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 has been helpful! All the best!