Ashley Judd's beautiful face - Who are we looking good for?

Ashley Judd is a very accomplished actress and current star of Missing on ABC. For some reason, the media has decided to attack this beautiful woman and claim she must have had some plastic surgical procedure due to her "puffy face." As a facial plastic surgeon, I know the trend in facial rejuvenation has come back to augmentation of the face to make one appear more youthful. Thus, I see why this can be a hot topic when you see a prominent actress with a puffier than usual face. Unfortunately, the tone of the conversation about Ashley Judd was not supportive, but was instead derisive in nature.

Ashley spoke out about this negative criticism in a recent article. http://popwatch.ew.com/2012/04/10/ashley-judd-puffy-face/

Ashley states she did not have any procedures done, but was actually on steroid medication for a sinus infection. It is very common for patients to retain water and even to gain weight while on steroid medication, which very commonly can show up as a "puffy face."

That being said, this whole situation makes me think: Who are we looking good for? I like to hope that my patients come in for me to help them look the way they feel, young and full of life. These are all personal choices that, in the end, only affect the patient. Why must we pick apart anyone's looks at all? Let's face it, Ashley Judd is a beautiful woman, whether her face is puffy or not. She is also an advocate for women everywhere. We should be supporting her as a female lead on a primetime show, not ridiculing her....

In my practice, many patients do require soft tissue augmentation of the face in order to appear more youthful. Usually, this is a very subtle change that corrects a soft tissue loss or depression. Many products can be used to give this youthful volumization; including Radiesse, Restylane, Juvederm, and the patient's own fat cells. When done correctly, cheeks and eyes are more youthful and brighter. Very commonly, women and men will lose fat in their cheeks and around the eyes making them appear more sunken or increasing the number of lines in the cheeks. Adding volume can make all the difference, without the need for incisions and usually very minimal downtime.

Feeze away the fat?

I tried Thermage, it definitely didn't give a nonsurgical facelift. I tried Ulthera, but didn't see any of the results they promised. These experiences have made me a lot more skeptical. I am slow to adopt new technology that hasn't been proven and like to believe that I am not easily swayed by marketing gimmicks. Therefore, I was very surprised when Coolsculpting delivered on its promise.

When the rep came to the office to demo the machine, my staff blocked out my time for over 2 hours! So, when volunteers were needed to have their belly fat frozen, I offered up my pooch. First, I had to get into some scrubs and have my tummy and love handles photographed from 8 different angles. Fun. Then, the rep drew all over my tummy where the machine would freeze my fat away.

I got comfortable on the table and then they dropped the bomb on me. The machine is placed on your lower tummy and the suction is turned on. Whoosh! All of your tummy skin and fat are sucked up into the machine! It feels really strange and mildly painful for about 10 minutes. Then the freezing starts to take effect and everything feels numb. Then, I hung out for an hour. It's kind of boring, so I recommend a book, Ipod, Kindle, laptop, anything to pass the time.

When the machine is removed, your fat comes out looking like a stick/wall of butter. Gross. This is quickly massaged down and you are good to go. The area is tender for a few days, up to a week. It remains numb to the touch for about a month, smaller area each day. Most people see results at 2-4 months, but I could tell at 1 month! I did not lose any weight, but tummy was flatter! I have always had a little pooch and it is gone. Needless to say, we bought the machine.

The "Ears" have it!

I was reading throught my article feed and found a very timely article in the Daily Mail.
http://www.dailymail.co.uk/femail/article-2069911/Rise-ear-job-Ears-sagging-heavy-earrings-age-say-surgeons-offering-cosmetic-fixes.html

This article discusses the changes women see in their earlobes as time marches on. Changes include stretched out piercings, saggy lobes, and really elongated lobes. There are multiple ways to fix these issues.
Lobuloplasty is usually performed to repair a stretched or torn piercing that will no longer hold an earring appropriately. In this procedure, the skin surrounding the hole is removed and the hole is sutured closed. Ears can usually be repierced 6 weeks later. Another variation of the lobuloplasty can be performed to reduce elongated earlobes. With the loss of fat in the earlobes, they can appear long and saggy. Removal of excess tissue at the ear/cheek junction makes this procedure simple and the scar almost invisible.
For many people, the loss of fat in the lobes can be overcome by simply adding volume. The use of hyaluronic acid fillers, like Restylane or Juvederm, can perk up a saggy lobe instantly! This is a simple, in-office procedure that can provide lasting results!

You would be surprised how many patients have been asking for rejuvenation of their earlobes.

How to keep your eyes bright through the holidays!

Well, it's that time of year again! The holidays are here and we all are busy, busy, busy! No one wants to have any downtime, but we all want to look our best. One of the biggest complaints I am hearing is about dark circles under the eyes (raccoon eyes).

Let me give you the lowdown on some easy fixes for this common condition....

Dark circles are usually hereditary and can get more prominent with time. If you think about the pathology behind dark circles, they are usually related to very thin skin overlying muscles and blood vessels under the eyes. These reddish blue structures are evident through the skin giving a bluish hue to the lower eyelid region.

Most people can cover their dark circles with concealer very effectively. The key here is to use the right type of concealer. The bluish hue is more easily covered with a contrasting color. A concealer with a peach or orange base, instead of pink, is usually more effective.

Sometimes, the skin and soft tissue around the eyes have gotten so thin that there is actually a trough or depression that shows up as dark circles. In this case, volume replacement is more effective. Hyaluronic acid fillers, like Restylane and Juvederm, are very effective in this area to plump up the skin and decrease the shadowing associated with volume loss. This is an in-office procedure with very little downtime. Most people will get no bruising and very minimal swelling. I like to have people come back 1-2 weeks after the injection for a possible touch up. I would rather put too little in the first time and add a little more at the followup visit to just perfect it. The biggest risk is over-filling the area and giving the patient a bulge in the lower eyelids.

Less commonly, a confluence of pigment in the lower eyelid region contributes to the look of dark circles. Usually, this is in a more darkly pigmented patient with some sun damage. Laser and chemical resurfacing of this area can really lighten the pigment and reduce the look of the dark circles. Many people will get a reduction of fine lines and wrinkles with these procedures as well! These resurfacing procedures are usually associated with up to a week of downtime, so they may be something to consider after the holidays.

I hope this helps, but remember, the real key to looking good is taking care of your body. An excess of alcohol, too little sleep, smoking, and salty foods can also make those dark circles look even worse. Have fun, but do so in moderation! Happy Holidays!

Snowy Day - quiet in the office!

Kind of nice to have a snowy day here in Cincinnati. You can really tell who the dedicated patients are on days like this! Of course, the postop patients will make it in, no one wants to keep a dressing on longer than they have to. I'm just always thrilled with the new consultations that still show up. Those are the people who are really serious!



My surgery tech told me yesterday that my lips looked really plump - No, I didn't put anything in them. But it did make me reflect on the different procedures we do use to plump up lips. I wrote a few months ago about the Permalip implant for the lips. I have done a few of them since that time and am pleasantly surprised! They look really natural - and, best of all, they are permanent! They are removable if you don't like them, but most wouldn't part with them!

I am also going to demo the new Ulthera this week. This is an ultrasound based tightening device. It is supposed to have really great results around the eyes with some moderate improvement on the neck and cheeks. Should be interesting! I will try to keep you posted.

Enjoy this snowy day - I can't wait to get home to the kids and sled!

No-needle 'Botox' is a few years away | needle, botox, years - Life - The Orange County Register

No-needle 'Botox' is a few years away | needle, botox, years - Life - The Orange County Register

Check out this link about a possible topical "Botox". This cream is applied to the skin to reduce the function of the orbicularis oculi muscle that works to help you squint. This could reduce the appearance of crow's feet and soften lines on the face. Sounds like more research needs to be done, but I thought I would share with all those interested!

Lips, Lips, Lips!

They say the eyes are the window to the soul . . . well, I say the lips are the window to the heart! We show so much emotion with our mouths and lips that belie our deepest feelings. How can we not try to make them as beautiful as possible?

There are so many things that affect the way our lips age. Smoking and sun damage are the two worst culprits. Sunscreen is your best friend when it comes to preventing fine lines and wrinkles. But smokers, wow, you just have to quit. Not only does the nicotine make your blood vessels contract and decrease the much needed blood flow to your tissues, but the constant sucking on those cigarettes causes those dreaded vertical "smoker's" lines.

Luckily, there are so many things we can do to help reduce the appearance of those lines and wrinkles around the mouth. Topical treatments, such as tretinoin cream, can penetrate the skin and cause collagen reorganization to decrease the appearance of fine lines and abnormal pigmentation. Injectable fillers, especially hyaluronic acids, such as Juvederm and Restylane can plump thin lips, even out assymmetries, and fill in fine lines around the lips. These fillers are easily injected and give instant gratification to the on-the-go woman. For those seeking permanent plumping, the new product from Surgisil called Permalip has really fit the bill. This product is a soft, squishy silicone tube with tapered ends that feels just wonderful in the lip! It is compressible and soft giving a natural, soft feel to the lips.

Lip augmentation is a very personal procedure. Some patients want a very subtle fill, while others are definitely out for drama. Just make sure you discuss your preferences with your surgeon to get the look you will love!

Thanks!