The introduction of new cosmetic injectables not only offers patients more choices in facial rejuvenation, but also more competitive pricing and better results produced by better technology.

New hyaluronic acid fillers

Many of the new injectable fillers headed for the U.S. are composed of hyaluronic acid gel, including:

• Belotero (Merz), a hyaluronic acid (HA) filler similar to Juvederm offered in three concentrations—soft, basic and intense
• Restylane Vital & SubQ (Medicis), thinner and thicker formulations in the Restylane family of injectable HA fillers
• Juvederm Voluma & Hydrate (Allergan), thinner and thicker formulations in the Juvederm family of injectable HA fillers

Belotero has already been filed with the FDA and is purported to provide an improved level of tissue integration that causes fewer incidences of lumps and bumps than other hyaluronic acid fillers.

Juvederm Voluma is used throughout Europe for adding large amounts of volume to the face, such as the chin and cheeks.  SubQ is also a large volume filler reportedly used for both facial contouring and body contouring, including buttock and breast augmentation.

Restylane Vital and Juvederm Hydrate are ideal for treating areas that have been historically difficult to correct with fillers, such as the back of the hands, décolleté and neck, and both purportedly offer wrinkle prevention by boosting skin hydration and elasticity.

Unlike Juvederm Hydrate, Restylane Vital offers a specialized automatic injection pen that regulates product injection volume and speed for more precise results.

Other innovative facial fillers

Novabel is the first injectable filler composed of spherical, flexible structures called Geleons, which are formed from marine brown algae extract.  This patented Geleon technology reportedly makes Novabel injections virtually pain-free and also improves skin elasticity.

In addition, the composition of Novabel is said to make injection easier and reduce swelling, making it ideal for adding volume to facial areas with thin skin, such as the eyelids and tear troughs.

In addition to Novabel, another new non-HA filler is working its way to the U.S.  Derma Veil, a pure collagen stimulator made of polylactic and polyglycolic acids (PLGA) will compete with Sculptra for a portion of the facial volume restoration market if approved.

Better than Botox? Naked botulinum type A injectables

In addition to injectable fillers, new botulinum type A neurotoxins Xeomin and PurTox are also poised to enter the U.S. marketplace.

Unlike Botox and Dysport, the active protein structures of PurTox and Xeomin products are not complexed to other, inactive proteins, leaving the active proteins “naked.”

As a result, it is theorized that these wrinkle relaxers may work faster, last longer and decrease the possibility of allergic reaction and development of blocking antibodies in patients.

PurTox has completed clinical trials and may be close to FDA approval.

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The segment profiles four women who had various skin rejuvenation treatments, including Thermage for body and facial skin tightening and Fraxel laser treatment for skin tone improvement. New York City dermatologist Dr. Anne Chapas also discussed the benefits of Thermage and Fraxel Restore treatments, as well as Isolaz acne treatment, with Today Show host Meredith Vieira.

Fraxel Restore was used to improve the skin tone of two women suffering from uneven pigmentation. Jill, 43, has fair skin and experienced considerable sun exposure without adequate sun protection as a child. She had Fraxel laser treatment to repair the sun damage on her face and was pleased with the results and new skin cell growth stimulated by the Fraxel laser.

“It really got rid of so much of the sun damage that I could see. It just makes me feel like I have fresh, new skin,” Jill said.

Dr. Chapas informed viewers about Fraxel Restore recovery, indicating that a few days of redness and dryness may occur after treatment. She also indicated that for best results, Fraxel Restore may need to be performed in a series of one to three treatments, depending on the needs of your skin.

Lisa, 46, also sought treatment with the Fraxel laser to improve skin discoloration she developed as a result of health issues and breakouts. In addition to undergoing treatment with the Fraxel Restore, Lisa also had Thermage skin tightening performed on her face to correct mild skin laxity.

The story’s final story highlighted another woman named Lisa, 37, who had Thermage treatment performed on her abdomen to tighten sagging skin lingering after two pregnancies. Dr. Chapas explained that Thermage skin tightening works by stimulating collagen production and indicated that Thermage results typically last one to two years.

Fraxel Restore skin rejuvenation and Thermage skin tightening procedures are available at the offices of Eugene plastic surgeon Dr. Lee Daniel.

The guidance was issued after an inquiry by the French Society of Plastic, Reconstructive and Aesthetic Plastic Surgeons revealed the PIP implants contain an illegal, untested silicone gel and are abnormally susceptible to rupture.   

Unlike women with the faulty PIP breast implants, women who undergo breast augmentation with the safe, FDA-approved breast implants used in the U.S. have a choice about when and how to address the unlikely event of a rupture caused by implant malfunction or breast trauma.

It is easy to detect a rupture in saline breast implants, as the implants will deflate and experience noticeable volume loss.  Silicone gel breast implants, on the other hand, require an MRI to detect ruptures because the signs are not as obvious. 

When ruptured breast implants do not cause problems with breast appearance or health, occasionally women will choose to forego revision surgery, however most pursue corrective surgery. 

Options for corrective surgery include:

• Bresat implant replacement, or breast augmentation revision
• Breast implant removal, or breast explant surgery
• Breast lift, or mastopexy, in combination with implant removal or replacement

Most women opt for breast augmentation revision to replace ruptured implants and maintain the size and shape of their augmented breasts, while others choose breast explant surgery, or breast implant removal, and do not have the ruptured implants replaced.  

When breast implants are removed without replacement, a breast liftmay be recommended to remove the excess skin that stretched to accommodate your previous implants.  A breast lift with augmentation revision may also be recommended if your breasts have experienced ptosis, or sagging, since the initial breast augmentation surgery.

If you experience a breast implant rupture, don’t panic, as there is no immediate health risk with FDA-approved implants.  Consult a board-certified plastic surgeon with significant experience performing breast revision surgery and discuss all possible options, so you and your surgeon can decide whether breast implant exchange or removal, with or without breast lift surgery, is best for you.

Only the first 10,000 people who donate will receive the Latisse free trial certificate. You might remember last year’s campaign led by Brooke Shields. This year, the effort is led by lifestyle designer Kathy Ireland, professional ballroom dancer Chelsie Hightower and style guide Bobbie Thomas. Watch the video to learn more about the campaign and see important product information about Latisse.

“With approximately 1.5 million bottles sold since launching the product a little more than a year ago, LATISSE is giving back by helping the Make-A-Wish Foundation grant the wishes of children. Through the campaign, we will double each individual’s donation, with a maximum donation of $250,000, through October 31,” said Robert Grant, President of Allergan Medical, a division of Allergan, Inc.

What are the causes of breast ptosis?

In general, the cause of breast droop is a combination of factors including breast size, aging, and gravity.  Large breasts are gradually pulled downward by gravity.  As your skin becomes thinner and less elastic with age, it stretches and becomes less able to maintain a youthful breast position.

A study recently published in Annals of Plastic Surgery sheds light on the lifestyle factors that contribute to breast ptosis.  Plastic surgeons found that age, significant weight loss, higher BMI, larger bra cup size, number of pregnancies, and smoking were found to be significant risk factors for breast ptosis.

Interestingly, “breast-feeding, weight gain during pregnancy, and lack of participation in regular upper body exercise were not found to be significant risk factors.”

Evaluating Breast Ptosis

A common way to measure breast ptosis is the Regnault classification, which is as follows in simplified form:

1. Pseudoptosis – the nipple falls above the fold, but the breast is hypoplastic and hangs below the breast crease.

2. Glandular Ptosis – the nipple is above the fold, but the breast hangs below the crease.

3. Minor Ptosis – the nipple is level with the breast crease.

4. Moderate Ptosis – the nipple is below the breast crease, but above the lower breast contour.

5. Severe Ptosis: the nipple is below the breast crease and below the lower breast contour.

Surgical Correction of Breast Ptosis

Using the classification system above, a surgeon can recommend the right procedure to correct breast ptosis.  Surgery to correct minor ptosis may be quite different from the procedure to correct a severe case of ptosis.  The usual procedure of choice is breast lift surgery / mastopexy.

“There are subtle things that we can do to make a change in the profile, in the definition of the nose, without changing their ethnicity, without intrinsically changing their appearance,” said Charles M. Boyd M.D.

For plastic surgeons, managing the patient’s expectations is important.  Likewise for the patient, communicating desires and aesthetic goals for rhinoplasty is critical.  Each doctor-patient relationship will go through this process in a different way.  One emerging trend facilitating this communication process is the use of 3-dimensional imaging to visually approximate the results that can be achieved.

“I use computer imaging and this is very helpful in pinpointing what patients are trying to achieve, and it enables them to see what’s in my mind as well,” said Steven B. Hopping M.D.

When it comes down to operating, there are of course, anatomical considerations for the ethnic patient.  View the article on modernmedicine.com to read how these surgeons approach rhinoplasty in patients of Asian, African American, and Middle Eastern descent.

The authors of the study claim there are physical, social and psychological factors that can predict interest in procedures such as:

• Breast augmentation
• Rhinoplasty (nose shaping)
• Liposuction
• Abdominoplasty (tummy tuck)

1862 participants responded to a survey.  The respondents who were interested in rhinoplasty, breast augmentation, and liposuction were motivated by “complex psychological factors.”   Doctors noted lifestyle factors such as divorce, history of teasing, education, self-image, body dysmorphic disorder, and the so-called Big-Five personality traits.

For other respondents, motivating factors appeared relatively simple.  Those who reported interest in abdominoplasty were interested in it exclusively. They generally mention a desire to repair the bodily changes occurring after childbirth.

Read more about this study in Plastic and Reconstructive Surgery, the journal of the American Society of Plastic Surgeons.

She’s featured in this video, courtesy of Project Beauty, a new consumer advice website launched by the American Society for Aesthetic Plastic Surgery.

Rhinoplasty, which can be translated into “nose-shaping” involves many surgical techniques to change and improve the shape of your nose. If your nose appears disproportional or unbalanced, rhinoplasty can help.  If your nose is short, long, wide, narrow, crooked, or just large, there are ways to reshape it while maintaining a natural appearance.

Is there an ideal or perfect nose shape?

Because your face has a different size and shape than the next person, your ideal nose will differ as well.  You may also want to consider your ethnicity, as many patients do not wish to completely erase these characteristics.

Aside these relative aspects of rhinoplasty, there are general aesthetic qualities that almost everyone will find appealing.   Most agree that the nasal dorsum should be straight, the tip should be somewhat narrow, and a small dip should be present between the nasal dorsum and the tip. Ask your plastic surgeon to show you photos of these qualities during your consultation.

Possible Alternatives

In some cases, the nose actually exhibits a normal shape and proportion, but it appears unbalanced because of a small chin.  Chin augmentation surgery with a facial implant can often solve this problem by increasing your chin projection.

The American Society of Plastic Surgeons recently publicized their annual statistics for 2009, and the results are optimistic.  They say plastic surgery is up 69 percent, minimally invasive procedures are way up, and consumer interest is continually rising.

Minimally invasive cosmetic procedures appear to be the driving force behind the 10-year increase.  Procedures like Botox, Injectable Fillers, and Laser Skin Resurfacing have spiked 99 percent since the year 2000.  People have many reasons to visit their plastic surgeon right now.  One of the main reasons is skin renewal.  “Skin is in,” says ASPS President Michael McGuire.

Read more on Plasticsurgery.org

Surgeons and other physicians in Spain claim they have performed a complete facial transplant on a man who suffered a self-inflicted gunshot wound. The 24-hour operation replaced the patient’s cheekbones, facial muscles, lips, jaw and other structures.

“This is the first full face transplant performed worldwide, as the 10 operations performed previously had been only partial,” said a statement released by Vall d’Hebron University Hospital. If so, the operation would be more extensive than the face transplant performed at the Cleveland Clinic two years ago.