Girls With The Mostest

G W T M · Last edited by G W T M on Sat Mar 03, 2007 12:56 pm; edited 2 times in total

Ask Dr. Naderi a question under this Sticky - lets keep all the questions under this sticky to make it easier for the doc.

BecinOz · Posted: Thu Mar 01, 2007 7:27 pm Post subject:

Hi Doctor

Just wondering what you think is the best procedure/filler to get lips enhanced ?
I had "restalyne" & loved it, but it went away very quickly.
I have been looking into "aquamid", but as it is permanent i really want to make the best choice.
Thankyou in advance,
Bec

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http://www.bagalleries.com/index....emId=21306&g2_navId=x280f6c3d

Heather1968 · Posted: Thu Mar 01, 2007 10:55 pm Post subject:

Hello Dr. Naderi:

What is your opinion of thermage and contour threading for the face?

Thank you,

Heather

Dr_Naderi · Posted: Thu Mar 01, 2007 11:53 pm Post subject:

Hi Bec,

Restylane and the other Hyaluronic acids are the best fillers for the lips. These include Hylaform, Captique, Perlane, and now Juvederm. They do not last very long but they do last longer than the collagens. Unfortunately the other fillers are not very safe in the lips. Some people have had good results but many have had major problems. The alternative is Advanta lip implants which are permanent strips of Gortex with the consistency and feel of Marshmallow! They are easily placed and easily removed if you dont like them. Try Juvederm if you liked Restylane and see if that lasts any longer for you.

Hi Heather,

Stay far far far away from any type of a Thread lift procedure. The idea that 8-12 barbed wires are placed blindly in your face to hold things up is ridiculous when you stop and think about it. The results are very short lived. Complications are plenty such as wires poking through the skin or facial nerves paralysis from the wires snagging the nerve branches and at best the results last a matter of months. This is a pure hype and a marketing tool used by many doctors to "sell" procedures instead of doing whats right and acting as doctors!

Thermage is OK only because the risks are very minimal BUT its a gamble. Some patients have fair results and some have barely any results. It may be a waste of money but at least its not terribly risky if done by an experienced doctor is professional. But be ready to be under-whelmed most of the time. I reserve this for a patient who either is too sick to undergo surgery or is a busy professional who cannot take even a few days off to recover from surgery.

Hope this helped.
_________________
www.VirginiaFacialPlasticSurgery.com

www.VirginiaRhinoplasty.com

DrNaderi@VirginiaFacialPlasticSurgery.com

[Online recommendations are not a substitute for actual live consultation and examination.]

chelliesmom · Posted: Fri Mar 02, 2007 3:11 pm Post subject:

Hi Doctor-

I underwent extensive surgery years ago with full maxillary and mandibular osteotomies which have left my lower left chin with some nerve damage. I also suffer a bit of PTSD from the lenghthy 6 month recovery from that procedure. A chin implant was to be possibly placed at that time, but as I was already under anesthesia for more than 15 hours they opted to skip in.

I really want to have the implant as well as a rhinoplasty, but am fearful of the chin implant recovery and the possibility of additional nerve damage. I feel comfortable with the risks associated with rhinoplasty but haven't found as much information on chin implants. In your experience, what is recovery like with regard to sleeping, eating, facial expressions, jaw use? Is it a good idea to combine the procedures medically?

Thanks!
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Heather1968 · Posted: Fri Mar 02, 2007 4:53 pm Post subject:

Dr_Naderi · Posted: Fri Mar 02, 2007 5:22 pm Post subject:

Hi chelliesmom,

Most surgeons use silicone or medpore or some form of a plastic chin implant. A small pocket is made and the implant is screwed in.

Other surgeons use layers of mesh which is cut into the proper shape and sutured in with no screws. In either case, the surgery should not take longer than 20-30 minutes and the risks are nerve damage creating numbness to the lips or possible infection requiring removal. In trained hands, both of these risks are very very minor. From the sounds of things, your osteotomy sites were more lateral and the anatomy of your chin should not have been affected so the chin implant surgery should be fairly "routine."

There is some pain and tightness the first 3 days. 40% of patients combine a rhinoplasty with a chin implant and compared to a rhinoplasty which is really not very painful afterwards, a chin implant can be quite uncomfortable - for a few days. Thereafter, your chin will feel swollen and tight for a few weeks but gradually you will not notice it. At about 6-18 months, you should not even "feel" that you have had an implant.

It makes sense to do both (nose and chin) together so you can recover at the same time and heal at the same time but only if you need it. Otherwise you can certainly do the nose and see how you like your new look and later on determine if you even want the chin implant.

Your surgeon should be able to help guide you through the decision.

Good luck.
_________________
www.VirginiaFacialPlasticSurgery.com

www.VirginiaRhinoplasty.com

DrNaderi@VirginiaFacialPlasticSurgery.com

[Online recommendations are not a substitute for actual live consultation and examination.]

Carissa21674 · Posted: Fri Mar 02, 2007 6:59 pm Post subject:

......
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34 y/o female
PS procedures: BA, Lipo, Rhino

[url=http://www.TickerFactory.com/]

[/url]

www.myspace.com/carissacnmt

Dr_Naderi · Posted: Fri Mar 02, 2007 7:09 pm Post subject:

I had an IPL in my previous practice in Indianapolis and I have one in our Spa. I am also an instructor at Yvonne De Vilar Aesthetics Institute where I teach Aestheticians on various "resurfacing" modalities including IPL/BBL.

Im not sure however what you mean by "intolerable skin." Can you please expand on that? Thanks

Briefly though, IPL is fantastic for treating melasma and hyperpigmentation and it is also good for general erythema from diffuse telangiectasias.

It should be used just like any other resurfacing modalities with respect to safety and skin color guidelines meaning it should be avoided in Fitz Patrick skin types 5 and 6. (it should be avoided in darker skin types).
The technology is also used for hair removal but it is not as effective as other laser modalities. It can be used for treatment of acne in some people but it is not very impressive usually for treatment of wrinkles no matter what the companies say.

Hope this helped.
_________________
www.VirginiaFacialPlasticSurgery.com

www.VirginiaRhinoplasty.com

DrNaderi@VirginiaFacialPlasticSurgery.com

[Online recommendations are not a substitute for actual live consultation and examination.]

Carissa21674 · Posted: Fri Mar 02, 2007 7:39 pm Post subject:

..........
_________________
34 y/o female
PS procedures: BA, Lipo, Rhino

[url=http://www.TickerFactory.com/]

[/url]

www.myspace.com/carissacnmt

Dr_Naderi · Posted: Fri Mar 02, 2007 8:04 pm Post subject:

Anything and everything in the field of cosmetic surgery can be "too harsh" or "too much" or "too over the top" or "too distorting" and on the other side of the coin the same exact treatment modalities can be "too unimpressive" or "too conservative" or make "too little of a change."

It all depends who does it and how they do it. IPL can be "just right" or it can be "a waste of money" or it can be "too harsh" and burn you! It all depends.

In the last 15-20 years, the CO2 laser and the IPL device and the Pulse-dye lasers have been the most revolutionary and impressive. All the rest have been slight 'evolutions" of these devices. There is a lot of "hype" out there. Fraxel for example works but not to the degree of hype and marketing you see and hear. But IPL devices are fantastic WHEN used in the correct patients BY skilled personnel.

You do become photosensitized and certainly if you use the Kerastick (aminolevulanic acid) with it. You should think of it like any other RESURFACING modality and treat it the same way. Just like you would have to stay out of direct sunlight after CO2 laser or after a chemical peel or after Dermabrasion, so too you will have to avoid direct sun after an IPL treatment but for a much shorter duration.
_________________
www.VirginiaFacialPlasticSurgery.com

www.VirginiaRhinoplasty.com

DrNaderi@VirginiaFacialPlasticSurgery.com

[Online recommendations are not a substitute for actual live consultation and examination.]

suebsue · Posted: Fri Mar 02, 2007 8:48 pm Post subject:

Dr., thank you for joining us! I have had two consultations regarding my mid-cheek area. My primary complaint is under eye crinkling although, at 43, I also have some lax skin in my jaw area and have restylane done in my naso-labial folds and at the corners of my mouth to "lift" my smile. I'm a horrible bruiser though so I'd prefer a more lasting solution.

One doctor I met with suggested endotyne but I'm very thin and I think if anyone would be bothered by feeling those devices under my skin, it would be me.

The second doctor I met with recommended making an incision under both of my eyes, slightly out past the corners and lifting vertically. This has some appeal as it seems to address several areas--under eyes, lower check laxity and it appears it would give me some improvement in my naso-labial folds. Is this a recognized procedure? There doesn't seem to be a standard "Mid-cheek face lift"...(i.e., different physicians approach it in different ways).

BTW, I've done IPL, fraxel, chemical peels, microdermabrasion. While they were helpful, I'd still like a more dramatic result.

Thanks in advance!
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Sue

Dr_Naderi · Posted: Fri Mar 02, 2007 10:34 pm Post subject:

Hi,

It sounds like both doctors suggested a mid-face lift of sorts. Its a good operation but I find less use for it these days. Mid-face lift creates weeks of edema and distortion for a minimal long term result that goes away in 5-7 years.

Cheek implants, or even fat injections are good alternatives. If you need a lower lid blepahroplasty then they can be combined.

If you like the effects of Restylane but are looking for a more permanent solution, you are in luck because the first FDA approved "permanent filler" has been released. Artefill is going to change the way many plastic surgeons practice because its a fantastic alternative to other fillers and a permanent fix.

The best thing is to see a few other surgeons until you find the right option or suggestion for you.
_________________
www.VirginiaFacialPlasticSurgery.com

www.VirginiaRhinoplasty.com

DrNaderi@VirginiaFacialPlasticSurgery.com

[Online recommendations are not a substitute for actual live consultation and examination.]

suebsue · Posted: Fri Mar 02, 2007 11:17 pm Post subject:

armychick · Posted: Sat Mar 03, 2007 5:39 am Post subject:

Sir,
Where in Virginia are you located? I am returning to the U.S. in June and will be in Virginia for several months in Starting Oct. I have had one conuslt for my upper eye lids by my surgeon here in Germany. Had one several years ago but that doctor scared me. He wanted to do a whole brow lift?!?! Which I dont want, my twin sister has had just her eye lids done to improve our Saggy upper eye lids and it looks great. Unfortunately, I will not have time to get the procedure done. Maybe I can get a consult at your office while I am there. And get the procedure done before I leave that area in December. What is the app. cost of this is your area?
Thanks
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Dr_Naderi · Posted: Sat Mar 03, 2007 9:10 am Post subject:

Dear armychick,

It would be my pleasure to see you when you get back to the U.S.

My office is in Northern Virginia. Sterling to be exact close to the Dulles Airport area.

Cosmetic consultations are complimentary in this area.

You can call 703-406-2444 to make and appointment.

I am not a huge fan of Brow lifts unless the patients brows are very very low.

Low positioned brows are actually a sign of youth. If you look at Fashion models in magazines, the all have arched brows but they are low. When the brow is pulled up high, it accentuates the superior orbital rim (eye socket) and makes the eyes look hollow or ghostly at times. Of course each patient is different and so is the way each surgeon does a brow lift but I think the operation is over used. We can talk about that when I see you.

Take care and be safe.
_________________
www.VirginiaFacialPlasticSurgery.com

www.VirginiaRhinoplasty.com

DrNaderi@VirginiaFacialPlasticSurgery.com

[Online recommendations are not a substitute for actual live consultation and examination.]

keetercat · Posted: Sat Mar 03, 2007 12:17 pm Post subject:

Hi Doctor,

first I wanted to say a big "thank you" for answering everyones questions! I know your time is very precious and I really appreciate you taking time for us.

I wanted to know what sort of treatment you feel would be best for broken capillaries, enlarged pores, and discoloration from acne. I don't really feel I have lots of wrinkles, I just wanted something to clear up the redness and make my skin look a bit more smooth, and less like an orange peel LOL.
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Jessica
Mentor high profile unders, 560 filled to 675cc's

Dr_Naderi · Posted: Sat Mar 03, 2007 2:25 pm Post subject:

Hi Jessica,

You're welcome!

As far as redness and broken capillaries, the options are IPL, Versa Pulse laser, Diolite laser, some YAG lasers, etc....

any of these options are fine in the right hands and any of them can cause complications in inexperienced hands.

As far as discoloration and ance scars and pores, good medical skin care combined with microdermabrasion and light peels can work over time to improve things slightly. More aggressive treatment would be Fraxel laser or medium depth peels. The most aggressive treatments would be CO2 laser or Dermabrasion. Nothing permanently changes pores but these modalities can help improve the appearance of pores. All of these options have to be weighed against their risks. These are good for people with lighter skin colors and should be avoided in olive skin and darker due to the high risk of complications. Sometimes if the acne scars are too deep or too wide then they must first be excised and treated surgically followed by resurfacing 6-8 weeks later.

Options are plenty which means NONE is a perfect option for everyone!

Seeing a few experienced surgeons and having them evaluate you and make recommendations is the best way to go.

Remember, you can always do more but you can't erase a complication from over-aggressiveness!

Good luck.
_________________
www.VirginiaFacialPlasticSurgery.com

www.VirginiaRhinoplasty.com

DrNaderi@VirginiaFacialPlasticSurgery.com

[Online recommendations are not a substitute for actual live consultation and examination.]

keetercat · Posted: Sat Mar 03, 2007 2:35 pm Post subject:

thank you for your reply! wow, that gives me lots of info/options to consider.
that is very true about not being able to erase a complication from over-aggressiveness, I will definitely keep that in mind. thanks again!

_________________
Jessica
Mentor high profile unders, 560 filled to 675cc's

Luxx · Posted: Sat Mar 03, 2007 4:14 pm Post subject:

Hi Dr. Naderi,

Welcome aboard!

What is the difference between Juvederm and Restylane for the use of lip augmentation?

I have very noticeable deepening frown lines between my eyes at the bridge of my nose. Would C02 laser be the best option for improving and/or removing them?

Also, I have visible tiny capillary veins around my nose, which has received laser treatment 3 times (twice at the same level and once at an increased pulse level), but the results showed no improvement. Any suggestions?

Thank you so much!