Submitted
by Laurie… I am a 45 year-old woman considering having
my upper and lower eyes “done”. I do not smoke and I am
in pretty good shape. What kind of recovery time can I expect and how
long
must I wait before I face the public?
Eyelid rejuvenation surgery provides a significant aesthetic improvement
with minimum down time. In fact, I believe it provides patients the “best
bang for their buck” when rejuvenating someone’s face. Remember
that when others look and communicate with you it is your eyes that they
are focusing on. In my practice, an upper and lower eyelid “lift” will
require about 1 week of true recovery. That is, absorbable sutures are
present on the upper lid and occasionally on the lower lid (I usually
remove the fat that causes puffiness away via the inside of your lower
eyelid and thus no sutures are required) for that period of time. You
will have minimum wound care and be able to go out on day 2. You will
be instructed to “take it easy” and not lift more than 10
pounds and limit your exercise to walking for the first week and then
over the next 3 weeks you will gradually increase your activity until
you are back to your baseline at 4 weeks. If laser resurfacing is done
as part of your procedure, the first week requires regular wound care
and will necessitate that you “hide” for 1 week. You will
require cover up makeup for several weeks before your comfortable with
your appearance. I tell my patients that regardless of what specific
procedures you have, you should look presentable at 1 week to return
to normal activities and by 6 weeks you should look great and feel
completely self confident in your appearance.
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Submitted
by Karen… Do you perform the so called “Lunchtime
Lift” and what is your opinion of this procedure?
The lift you speak of is a very non-specific, non-medical term. I
perform several different procedures on a regular basis including,
stringlifts,
ultralifts, Grecian urn neck lifts, and extended SMAS facelifts in
order to rejuvenate the face and neck. They range in terms of indications,
invasiveness, recovery time, expected results and cost. Let me state
very clearly that there is no reputable facial plastic surgeon who
will
promise to provide surgical facial rejuvenation, regardless of technique,
and get you back to work the next day. It is simply untrue. Buyer
Beware.
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Submitted
by Dana… I would like to try Botox treatments
between my eyes…on average, how many treatments are needed,
at what intervals and what is the cost per treatment?
Botox is the treatment of choice for unwanted lines between the
eyebrows. It delivers exceptional patient satisfaction the first
time it is used.
The onset of action is about 4 days. The medicine will get more
effective in smoothing lines in this or any other facial area that
we treat over
the following week to 10 days. The effects usually last between
4 and 6 months at which time you will have to redo the treatment
to maintain
the desired results. Botox is a wonderful technique in my aesthetic
armamentarium. However, the quality of the results that you can
expect are directly
related to the experience, judgement and technique of the injector.
At the Emory Facial Center, I perform all Botox and skin filler
injections personally. In fact, I am one of a select group of highly
skilled Botox
injectors that have been selected by the company that makes Botox
to instruct fellow physicians through out the United States on
the proper
use of their product. In my hands, Botox not only permits me to
soften lines and wrinkles, but also enables me to truly sculpt
the face. Botox
costs range from $200 to $400 per area depending on the amount
of Botox I need to use and the number of areas we are treating.
Treating multiple
facial areas enables us to offer multi-site discounts.
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Submitted by Dianne… how much do you charge for a
consultation?
Dr. Yellin sees patients at the Emory Facial Center, 993-C Johnson
Ferry Road, Suite 215, Atlanta, located at the junction of GA 400
and I285.
A personalized facial aesthetic consultation, discussing all aspects
of facial enhancement from skin care to surgery, lasts about 1
hour and costs $100. You may schedule an appointment with Dr. Yellin
by
calling
404-303-0101.
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Submitted
by Alicia… What
is a “Lifestyle
Lift” and do you perform this procedure?
The “Lifestyle Lift” is a marketing term, not a medical
term. I have seen it applied to a very limited facelift in which (1)
no true neck lift is performed, only a small amount of lateral cheek
tightening; (2) a skin-only eyelid lift is done; and (3) the procedure
is performed under local anesthesia in an office setting, which means
that the patient is fully awake during surgery. The procedure has
been touted as taking only one hour and allowing patients to get
back to
work the next day.
In my
opinion and based on my experience, such marketing claims are based
on ideal or optimal scenarios that do
not obtain for
every patient: the procedure itself can take several hours, and
the recovery time until a patient can comfortably return to work
can
be a week or more. I am also concerned that procedures described
as “Lifestyle
Lifts” may be made available in a setting that provides the same
limited procedure to all patients without an individualized assessment
of a patient’s needs and objectives. In some instances, the
doctor performing this type of limited procedure may not see the
patient until
moments before the procedure is performed.
I strongly
suggest that anyone considering this procedure obtain a second opinion
and not
simply use price but also honesty, artistry, individualized analysis
and attention,
and surgical expertise as a guide when making such an important
decision as to who will operate on your face. Buyer beware!
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Submitted by Elizabeth… I had a baby two months ago
and I am still breast feeding. Is it safe to have botox injections
at this time?
Botox is a wonderful therapy for unwanted facial lines cased by excessive
facial muscular activity. Botox also permits me to “sculpt” a
face to promote facial attractiveness. However, it should not be performed
if the patient is either pregnant or breast-feeding. Enjoy your baby
and see me after he/she has been weaned.
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Submitted
by Thomas… I have acne scars from my teenage years…what
can I do to get rid of them?
Unfortunately, scarred skin from acne or other injuries to the skin
can never be made to be “normal”. The skin is simply different.
It is missing normal anatomic structures that we cannot replace. However,
if your acne is no longer active and you have not used accutane for
at least 1 year, Laser resurfacing can improve the appearance of your
skin and hopefully allow you to feel confident about your facial appearance.
I do not recommend dermabrasion (quite different from microdermabrasion
which will do nothing for you) but this is an alternative therapy for
facial scarring as well. If the scars are very deep, subcision and
filling with Restylane® (a skin volume filler) is indicated. A
consultation would be required to determine a specific treatment plan
for you.
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Submitted
by Sandra… I am a 55 year old woman but I look more
like 45. I do have some fine wrinkles around my eyes and lips…would
chemical peels or laser resurfacing work for me? What is the difference
between these two procedures?
As you describe your issues, resurfacing which is what you are referring
to, does not jump to my mind as the first line of therapy. But, to
answer your question, laser resurfacing uses a single wavelength of
intense, collimated light, which has been chosen to interact with the
water in your skin to vaporize the outer layers of the skin, tighten
the tissues and stimulate your own collagen to plump the lines and
wrinkles in your skin. Chemical peels use acids of varying strengths
to accomplish similar things but in my opinion with much less specificity
and control.
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Submitted
by Janice… Would botox injections help reduce
frown lines on the sides of my mouth?
Advanced Botox injectors such as myself do use Botox to help with the
frown lines on the sides of the mouth but this area often needs volumetric
fillers as well to accomplish a significant correction. A personal
consultation would clarify what therapies are best in your particular
case.
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Submitted by Brenda…. I am a 30 year old African-American
woman with acne scarring. I have had microdermabrasion and chemical
peels
from my dermatologist with little results. Is a laser procedure an
option for Black skin? My complexion is medium brown.
No, unfortunately laser resurfacing will expose you to excessive risk
of skin color changes, either permanent dark areas or light areas.
I cannot recommend it for your problem with your skin coloration.
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Submitted
by Andrea…. I have very dark under-eye circles.
I do not have any under eye bags, just the opposite. The area is concave
with a facial line that borders and accentuates them. Is there any
procedure out there that will help me?
Absolutely there is. This area you speak of is called the tear trough.
It is an area that I particularly like treating because it has such
a powerful aesthetic impact on facial appearance and the correction
is simple. The area needs volume to fill the hollow and soften the
transition from eyelid area to cheek. This is a very important aesthetic
zone when trying to improve appearance and promote youthfulness. The
volumetric filler of choice in my practice today is Restylane, which
can be injected in minutes and will lead to about 1 year of correction
before it needs to be done again. You should be off all aspirin products,
non-steroidal anti-inflammatories (advil, motrin, nuprin, naproxyn,
etc.) vitamin E and all herbal supplements for 2 weeks before and after
treatment to reduce bruising. You can also start taking Arnica (found
in health food stores) 1 week before treatment to mitigate bruising
as well. However, this area will bruise and swell after treatment regardless
and you should plan on wearing some makeup in this area for about 1
week following treatment as a cover-up.
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Submitted by Natalie…. I have sort of a “flat
face”.
I need cheeks and face contouring. Is that possible?
Yes. Facial volumetric contouring can be accomplished with implants
or injectable long-lasting collagen stimulants such as Sculptra or
fat injections. Typically, implants are the procedure(s) of choice
and several different materials are available. These are surgical procedures
and require about a week of true healing. The selection of the implants
size and type and the placement of facial implants do require excellent
judgment and experience and I would encourage you to have a personalized
consultation as this is not an aesthetic decision that should be made
by the inexperienced surgeon.
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Submitted
by Jocelyn… I think I am getting bags under my eyes.
What is the easiest and least painful way of getting rid of them?
“
Bags” are often caused by small pockets of fat protruding forward
causing puffiness under the eyes. If this is your problem, the simplest
approach is to remove the excessive fat but leave enough fat behind
to create a normal contour to the lower lid area. I accomplish this
in the most minimally invasive way possible. The most direct approach
to these fat pockets is from the inside (pink) area of the eyelid.
A small stab incision is made over each offending pocket (there are
up to 3 pockets in the lower lid that need addressing) and the fat
is simply teased from the surrounding tissue and removed. If the skin
of your lower lid is wrinkled or loose a laser can be used to tight
this area and leave no scar at all once it has healed. It is a very
elegant procedure and one with high patient satisfaction.
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Submitted
by Terri… I have been using restylane and botox
for two years with good results. Now I am considering a facelift. Would
the botox and restylane interfere with the surgery?
Absolutely not, Botox and Restlane are most often used as line and
wrinkle therapies in the upper third of the face and around the mouth
area which complement a facelift, a procedure intended to enhance the
lower third of the face, jaw-line and neck area.
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Submitted
by Caren… Is
there a permanent procedure that will make lips fuller?
Absolutely,
there are lip implants that will provide lip volume enhancement and
can be placed under local anesthesia, in an
office setting in about
1 hour. The products I currently use include Soft Form® and Advanta®.
Both provide a permanent, fuller, natural appearing lip. However,
implants do not give me the same degree of artistic control that
injectable
fillers provide. If I need to enhance overall lip contour, currently,
I will use Restylane® to define and balance the lip aesthetic.
This will provide about 6 months of enhancement before it has to
be redone. What ever you do, never have fat injections into your
lips.
This procedure is very unpredictable and is not recommended.
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Submitted
by Rachel… Is it best to have cosmetic surgery in your
40’s, 50’s or 60’s? Should you wait until you
really need it or should you start when you first notice signs
of ageing
Chronological
age is never the determining factor for deciding when facial rejuvenation
surgical procedures are appropriate.
What is
important is the severity of the particular aesthetic concern
and how much it
bothers you. A decision to have aesthetic surgery should never
be made based on other peoples concerns; for example pressure
from a
spouse.
When rejuvenating ones face, it is frequently the case that you
are trading skin laxity for surgical scars. Therefore, you should
have
enough ”going on” to justify such a trade.
However,
I believe that a bit of maintenance, that is small procedures
done when needed,
are the best way to maintain attractiveness. This avoids drastic
change, which is often more noticeable. Well-performed aesthetic
facial surgery
should enhance your appearance not telegraph to others what
you have had done. Additionally, if you “need” something
done why not get it done when it first bothers you. You will
then have the enjoyment
of your procedure for that much longer. Also, the younger and
more elastic your skin often the better the results overall.
Finally, having
a procedure like an eyelid tuck or a face and neck lift will
not effect your ability to have it done again, let’s say
15 years later, if it becomes necessary.
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Submitted
by Rhonda… Can
people of color have cosmetic surgery?
People of all
races can enjoy the benefits of cosmetic facial surgery. The
specific risks are reviewed with each patient
prior to surgery
and often these risks may vary slightly according to ones ethnicity,
but cosmetic surgery can be performed safely in just about
anyone. Of course, if you have a history of keloid scar formation,
which
is scarring that is raised, thickened and goes well beyond
the borders
of the injury, this may preclude elective surgery as an option.
However, I can tell you that many individuals, particularly
people of color,
have been told that they have a keloid scar from some injury
or procedure in the past, when in fact that is not the case.
Therefore,
I would
recommend having it looked at by an expert before making any
decisions regarding facial cosmetic surgery. Finally, skin
resurfacing with
a laser, dermabrasion or a deep chemical peel is rarely indicated
but
never appropriate if the patient has dark skin. The risk of
permanent color change to the skin is simply too great. Back to top
Submitted
by Joy… Can cosmetic surgery erase
acne scars?
Unfortunately,
scars from acne or other types of skin injury are permanent
changes to the
skins architecture. Scarred skin is fundamentally different
than unscarred skin. However, laser resurfacing, excision of deep,
ice-pick scars and filler injections can often make scars appear
much less noticeable. Additionally, there are mineral
based makeups that
we can recommend that will help camouflage an area without making
it look like you are wearing heavy makeup or concealer.
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Submitted
by Mindy… What is the most common type of cosmetic
plastic surgery?
I
refer you to the American Academy of Facial Plastic and
Reconstructive Surgery web site to see
the latest statistics regarding frequently
done facial plastic surgery procedures. The link to the academy
can be found on my website, in my bio section at EmoryFacialCenter.com.
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Submitted
by Cheryl… I had a chin implant 12 years ago
and I have never been happy with the results. Can
the implant be
replaced or removed after this long?
Yes,
chin implants can be revised or removed at any time.
Depending on the material used it may be more
or less difficult, but the
implant can be removed. There are many different styles of
implant available
today. Depending on your needs, the proper implant can be
placed with the intent of making you happy.
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Submitted
by Tony… I am a 60-year-old man and would like
to get rid of my “turkey neck.” What
is involved in that procedure?
You
have two options to fix the problem you describe.
With either procedure, the excess skin is removed
and the deep neck
tissues
are contoured
and tightened. The first option is a traditional lower
face/neck lift, which places the scars under your
chin and around the
contours of your
ears and along the hairline behind your ears. This operation
is often the best option since the scars are well hidden
and it addresses
not
only your neck but the cheeks, jowl and jaw line as well.
The other operation is called the Grecian urn neck
lift. It is
appropriate when excess skin, rather than a heavy neck
is the overriding
problem
and
the individual is not concerned about improving their
facial appearance, only their neck. This is a direct
excision
of the neck skin with
the scar placed in the midline of your neck. Most of
this scar is not easily
seen as it lies under your chin but a portion of the
scar can be seen lower in your neck, particularly while
it is healing.
After
6 to 12
months as the scar fully matures, it becomes much less
noticeable. This operation is simpler to perform,
easier
to recover from,
gives a fantastic neck contour and is half the price
of a traditional face/neck lift. The final decision as
to which operation is
best for you can
only be made during a personal consultation. I refer
you
to my website to view some examples of these two
procedures, EmoryFacialCenter.com.
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Submitted
by Grace… When
I was young I had acne and now I have a lot of deep
pores. What can be done to smooth
them out?
Keeping
your pores clean with a professional, well-done facial
and good home care is the first step. Microdermabrasion
can
provide temporary
improvement in your skins appearance and the addition
of Intense Pulsed Light (Photofacial) can potentially
provide
some long-term
improvement
in pore size. However, oilier skin, which is more
prone to acne in the first place, often has larger
pores.
The good news
is
that oily
skin looks more youthful longer than drier skin types.
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Submitted
by Beth… I know that in some teaching hospitals,
patients can get on a waiting list to have student
doctors perform certain procedures
at a reduced cost. Is there a similar process
for facial plastic surgery at Emory? If so, how do
I get
a consultation?
At
the Emory Facial Center, it is important to stress that
under no circumstance does a student
doctor
or resident ever operate
on my cosmetic
patients. I do all surgery personally. However,
you can have a facial plastic surgery resident perform
your surgery
at Grady
Hospital
for
substantially reduced cost relative to my fees.
I
recommend that you contact Grady Hospital and
make an appointment
with the Otolaryngology
Department, mention that you are interested in
Facial cosmetic
surgery
and that you would like an appointment when the
facial plastic surgeon is in clinic. Good Luck.
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Submitted
by Elaine… I have spider veins on my face
and neck. Can a facial plastic surgeon help
with this problem?
Yes,
however, the key point is that you must
make sure the surgeon you choose has the
proper laser
and the
knowledge and
experience
to use it safely. KTP and pulsed dye lasers
are frequently employed to
treat these problems. For fine spider veins
or generalized facial redness, Intense Pulsed Light
(IPL) is the
treatment of choice.
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