Nothing sparks discussion quite like celebrity plastic surgery, and boy were the sparks flying after Madonna’s Super Bowl appearance. 

Most people agree the Material Girl looks amazing for her 53 years.  She has maintained her athletic physique and “cut” biceps.  What she hasn’t maintained are chiseled cheekbones and a pointy chin.  Madonna seems to have fallen victim to the “pillow face” trend.  Think Priscilla Presley and Joan Rivers for good examples of the pillow face.

As we age our facial fat volume decreases and facial skin loses elasticity. The result is a general change in the shape of the face. A youthful face is heart shaped, broader in the cheeks and narrowing toward the chin.  With age, fat loss and draping skin result in an upside down heart shape with hollowed temples and eye sockets and sagging skin forming jowls.

Replenishing volume is key to a more youthful face and there are several methods to do this.  Most notably are injectable volumizers such as the collagen stimulators Sculptra and Radiesse.  Although long lasting, both Radiesse and Sculptra treatments need repeating.  Fat grafting with stem cell transfer, where one’s own body fat and stem cells are harvested, purified and then injected to plump the area may be a more permanent solution. 

Gilbert Lee, M.D., FACS (San Diego, CA) is an expert in the field of fat and stem cell grafting spending years perfecting the technique.  Stem cells with their rejuvenative properties are highly concentrated in the body’s fat stores.  Thus, when one harvests and concentrates fat cells, they also concentrate stem cells which help the grafts to survive, and help to rejuvenate the skin quality of the face.  Fat and stem cell grafting is done in two steps, performed at the same setting:  harvesting and grafting. During the first step, liposuction is performed on a predetermined area to obtain a required volume of fat and stem cells. The fat is then processed and purified to prepare it for re-injection. The second step is the injection of the fat and stem cells into the face or other recipient site.

Because about 50% of the injected fat will be reabsorbed by your body, it is common practice to slightly “overfill”. This overfilling ensures that after your body has absorbed a portion of the fat, the permanent fat that is remaining gives the desired amount of correction.  

Unfortunately, in the hands of an unskilled practitioner, the risk of too much fat being injected and ending up with a pillow face is a very real possibility.  Before you settle on this type of volume correction, do your homework. Ask your doctor how many fat grafting procedures he has performed and request to see before and after photos of his actual fat grafting patients.  Always start conservatively with any filler correction and remember: fillers come and fillers go, but fat cells are forever.

Learn more about fat grafting with Gilbert Lee, M.D. at www.changesplasticsurgery.com or call us at 858-720-1440. 

Gilbert Lee, M.D., F.A.C.S. at Changes Plastic Surgery & Spa in San Diego, California sees the trend toward more male plastic surgery cases, noting that more and more men are seeking cosmetic procedures as a way to look more vital and youthful in the job place. Divorce also motivates some men to turn back the aging clock in hopes of appearing more energetic and attractive as they enter the dating scene again. 

Currently, a little over ten percent of Dr. Lee’s patients are men, but if the national trend continues, he will be treating more and more of the male population. Data compiled by the ASPS (American Society of Plastic Surgery) for 2010 shows an increase in male eyelid surgery, liposuction of the love handles and breast liposuction surgeries with other non-surgical treatments gaining in popularity.

The top five male cosmetic procedures at Changes Plastic Surgery & Spa in San Diego are:

1. Eyelid Surgery including treatment for undereye bags and correction of tear trough deformity.
   Eyelid surgery or blepharoplasty is performed essentially the same way for men and women. For men who complain of undereye bags, Dr. Lee may suggest the insertion of tear trough implants to smooth the lower lid to cheek transition and achieve a more youthful contour.
    
2. Injectable wrinkle correction (BOTOX®, Dysport®, as well as many injectable fillers).
   Non-surgical, but highly effective injections can smooth out even the toughest of worry and frown lines, giving way to a more relaxed and pleasant facial appearance.
    
3. Male Breast Surgery for the treatment of gynecomastia.
   “Gynecomastia” or benign enlargement of male breast tissue can be quite disconcerting for men. The removal of fat and/or glandular tissue from the breasts results in a flatter, firmer and more masculine chest.
4. Liposuction
   The ideal male body type is athletic with a “V” shape of broad shoulders and narrow waistline. As men age, fat tends to accumulate around the abdomen and flanks. Most males over the age of 30 have “love handles” which can be removed through liposuction.
   
5. Laser Facial Rejuvenation
   Outdoor activities and constant sun exposure in San Diego can leave men with facial brown spots, uneven pigmentation and rough texture. All are signs of photo-aging. Rejuvenating facial skin with laser treatments results in an overall more youthful appearance.

Dr. Lee is a triple board-certified plastic surgeon and has been voted Top Doc in Plastic Surgery by his peers in the San Diego Medical Society for five consecutive years (2007-2011). He has been changing the lives of his patients since 1994. If you are interested in a consultation with Dr. Gilbert Lee, please call Changes Plastic Surgery & Spa at 858-720-1440 or fill out our online request form.

1.   Neck bands.

     Botox is a safe and effective treatment for relaxing vertical neck bands. The bands typically are noticeable from the jawline to the collar bone and    become prominent when they separate into bands as we age. To flatten/relax the bands, Botox is injected along the length of the platysma muscle.

2.   Raise the eyebrows.

     In the upper face, there are muscles that pull upward on the brow and those that pull downward. The key to a successful brow-lift is to relax those facial muscles that are pulling downward on the brow. In doing so, the muscles that pull upward take control and make the eyes appear more open and alive.  

3.   Urinary incontinence.

     Botox is sometimes injected into the muscles of the bladder to treat incontinence. Botox blocks the release of chemicals that cause muscle spasms. The injection, given under anesthesia, is effective for nine months to a year. 

4.   Relax teeth grinding muscles.

     Botox works to relieve the muscles used to grind your teeth. Three sets of muscles are involved in moving the jaw. These muscles  can become overactive, causing the jaw to clench unconsciously.  Botox can be injected directly into the muscle to relax the jaw and make clenching the teeth difficult.

5.   Orange peel chin.

     Many individuals form uneven skin on the front of the chin, often from repeated contracture. It can resemble the appearance of an orange peel. A few tiny injections of Botox or Dysport into the tip of the chin can help relax the contractions and reduce the appearance of peau d’orange.

You may be offered a treatment like those listed above. The main problem with off-label usage of any drug is that the long-term studies have not been conducted to prove that they are safe. However, if you are in the hands of a skilled and certified Botox or Dysport technician and they have routinely performed the off-label application without complication, you can feel fairly confident in its safety.

For more information on Botox and Dysport treatments, please call Changes Plastic Surgery & Spa at 858-720-1440.

The eyes are the windows to the soul.  They hold a gaze and are the first thing people see when looking at our face. It is also the first place we notice the signs of aging.  Thinning skin, sun damage and facial expressions take their toll on the delicate eye area. Dark circles appear and eyeshadow disappears as sagging skin droops over the lid. Crow’s feet and laugh lines appear and stay there even if we’re not laughing!  But aging eyes are nothing to cry about.  Rejuvenating the eye area is relatively simple and most importantly, addressing the eye area first results in a more youthful appearance for the entire face.  

Although blepharoplasty (eyelid lift) is a common surgical solution to the aging eye area, non-surgical options are discussed here.

Dark circles under the eyes can make you look tired and worn out or worse, unhealthy.  As the skin in the eye area thins with age, blood vessels beneath the surface show through creating the illusion of dark circles. In some cases the dark circles are simply shadows caused by a hollowing of the area above the cheeks (tear troughs). One way of masking this appearance is with the injection of hyaluronic acid to plump the area and provide better support for the undereye skin.  Restylane and Juvederm  are two most commonly used products to achieve this. Both products are affordable, effective for approximately 8-12 months and can be performed in a single office visit. A patient’s own fat can also be injected into the tear trough hollows for a more permanent correction.

Hooded and sagging eyelids can be tweaked with a little Dysport or Botox injected to simulate a mini-browlift and raise the lids. Although a temporary fix lasting 4-5 months, both products are moderately priced and well tolerated by all patients.  Dysport or Botox can also be injected into the crow’s feet area to minimize the muscle movement and allow crow’s feet wrinkles to relax and fade.

Wrinkled, crepey and sagging eye area skin can be improved with laser.  Using fractionalized CO2 (carbon dioxide) laser, such as Lumenis Total FX, the delicate eyelid skin can be resurfaced to erase existing lines, improve texture and add a few degrees of tightening to lift the lid without surgery (see below).  The CO2 Total FX offers results with only one treatment and can be performed specifically for the eye area at a fraction of the full face price.

Gaze into your own eyes and see the possibility of a new reflection. Younger, happier and natural looking with the help of a few non-surgical eye-openers.  Visit www.facebook.com/ChangesPlasticSurgery or www.changesplasticsurgery.com for more information and pricing on non-surgical facial rejuvenation.