Of the effects of aging, some of the most noticeable and the most troublesome are lines and wrinkles. These can begin to appear nearly anywhere on the face, in varying levels of severity. Early treatment using dermal fillers and injectables can slow their progression and reduce their appearance.

However, certain lines and wrinkles, like those on the forehead, can deepen enough to form creases even with these treatments. Many treatments used elsewhere around the face can help, but they are often not effective enough, using normal and safe amounts to provide the desired results.

Recently, the FDA has approved Radiesse® to treat moderate to severe lines and creases in the face caused by the loss of volume or fat. Radiesse® differs from other dermal fillers available, not just in the composition but in how it works and the results it provides.

Radiesse® is made from microspheres of calcium hydroxylapatite. The microspheres are contained in a gel to create a thicker substance than other fillers. Like the hyaluronic acid found in other fillers, this molecule is naturally produced and located in the body, though its production slows with age.

Since this gel can restore lost volume, it is injected deeper into the skin to provide more outward pressure. Unlike hyaluronic acid, the results from Radiesse® can be seen immediately following the treatment session. The results also last as long or longer than other available treatments.

Not only is Radiesse® helpful in treating moderate to severe lines and creases, but its thickness also makes it a great alternative to some other cosmetic procedures, such as a rhinoplasty, to address certain dermal deformities.

You do not need an invasive procedure to reduce or eliminate the appearance of moderate or severe lines and creases on your face. Radiesse® can help provide the aesthetic enhancement you want, and treatments are easy enough to fit into your overall aesthetic or cosmetic plan. Call the Center for Plastic Surgery in Highlands, NC, at 828-526-3783 or visit www.plasticsurgerytoday.com to schedule a consultation.

As we age, the skin and supporting structures lose collagen and elastin, the things that give it strength and elasticity.  Gravity and the muscles that are attached to the skin in the face stretch the skin and cause it to wrinkle.  Additionally, we lose subcutaneous tissue.  The result depends on which of these changes predominate.  If stretch is the largest component, then surgical removal of the excess skin with a facelift, blepharoplasty, etc. is required.  However, if volume loss and wrinkling are most prominent, then re-filling the area using Today’s Liquid Lift™, a nonsurgical, noninvasive procedure, is all that is needed. This works equally well for both men and women.

Non-Invasive Liquid Lift™ Procedure

This approach uses a combination of skin care, Botox®, and a filler, either off the shelf or your own fat, to reverse the signs of aging.  What is used, depends on the particular problem.

The most important step in treating wrinkles is beginning the use of tretinoin (Retin-A, to stimulate collagen) and Obagi®’s patented ELASTIderm® (to stimulate elastic tissue) along with basic skincare consisting of a cleanser, a pH balancer, an exfoliant, and a good zinc oxide sunblock. If the wrinkle is caused by underlying muscle action, and the muscle is not necessary for normal function, then we use Botox® to stop the muscle action on the skin.  This is all that is necessary for fine wrinkles.  For deeper wrinkles, we add micro-needling to increase dermal (the support layer of the skin) production of collagen to reduce the wrinkles. If the wrinkles are quite deep, we then fill the wrinkle using Juvéderm Volbella™, a filler that generally does not cause the Tyndall effect (a blue line where the filler is injected close to the surface).  Previously for these deeper wrinkles, we used either a leveling peel or laser to remove the top layer of the skin to the bottom of the wrinkle allowing the skin to regrow smoothly.  This, however, has a 2-3 week downtime, as opposed to the no downtime of what we do now.

Botox® can also be used to improve facial features if removing a certain muscle function allows opposing muscles to achieve the result that you desire.  The most dramatic result is to open the eyes when the muscles below the brow are pulling the brow downward and removing those muscles allows the muscle in the forehead to elevate the brow and open the eye.

If the problem is related to loss of volume, then refilling that area with either your own fat or a filler corrects it. The choice of which depends on how much fill is needed, where the filler is needed, and other factors, including cost. Initially, if you wished a long-lasting result the only choice was fat.  However, the newer fillers are now much longer-lasting, (one Juvéderm® Voluma) up to five years or longer. Fat is still excellent for filling large areas and is quite long-lasting.  For small areas, an off-the-shelf filler is excellent, exceptionally convenient, and cost-effective.

Filler Choices Other Than Fat

You will frequently see these called “dermal” fillers.  However, we have almost never used them intradermally and, even now, there are only a few that work well placed in the dermis without causing a Tyndall effect. Some are intended for only subcutaneous and deep subcutaneous placement but still get labeled as “dermal” fillers by many people. There are a variety of off-the-shelf fillers used. The basic types of these include:

• Hyaluronic acid, the most common with many brands.
• Polymethylmethacrylate beads, Bellafill®, an essentially permanent filler but with frequent problems.
• Calcium hydroxylapatite, Radiesse®, still a good filler for deep filling, but not as long-lasting as Voluma®, a hyaluronic acid filler.
• Poly-L-lactic acid, Sculptra®, a stimulant filler requiring multiple injections to achieve the desired result with less longevity than some of the hyaluronic acid ones and calcium hydroxyapatite

Today’s Liquid Lift™ Filler Used

Dr. Buchanan prefers the Juvéderm® family of hyaluronic acid fillers because of their excellent performance, safety, and because they are more long-lasting than any other comparable filler on the market.

These include:

• Juvéderm Ultra™, excellent for most superficial applications including the lips and when increased volume above what is injected is desired.  Lasts about a year
• Juvéderm Voluma™, excellent for volume filling when the filler can be placed directly on bone or muscle.  We have had it last over five years, though it is supposed to last only about two years.
• Juvéderm Volbella™, excellent for superficial filling, particularly the lips, for finessing, and filling lines and wrinkles. It lasts at least a year.
• Juvéderm Vollure™, excellent for lips and volume filling where we need to fill the superficial or deep fat compartments not overlying bone. Lasts at least 18 months.

Using the latest techniques, it is our goal to provide the desired outcome with a procedure offering the quickest recovery and optimal results. We listen to you and strive to provide a natural result with the least invasive means.

Where reasonable, before injection, we use either a local or regional anesthetic before Botox or filler injection. Other than that, there may be only a mild stinging sensation. The procedure takes about 15 minutes to an hour, depending upon what is done with essentially no downtime.

Regain Your Vibrance with a Liquid Lift

Give yourself the gift of youthful vibrance with Today’s Liquid Lift™. Also, ask about repair using the techniques for aged hands. Contact the Center for Plastic Surgery serving Highlands, NC and the surrounding community, by calling 828-526-3783 to schedule your consultation with Dr. Robert Buchanan.

In the past several years, plastic surgeons have heard patients loud and clear. As effective as surgical procedures are, the vast majority of patients would like to address the signs of aging and other cosmetic objectives without setting foot in the operating room. We understand the draw of nonsurgical cosmetic treatments. We also understand the value of them, their safety, and what they can accomplish with little, if any, downtime. In our Highlands, NC office, we offer a wide range of nonsurgical treatments to refresh and improve your look. 

A Little Something to Keep in Mind

Nonsurgical anti-aging and cosmetic treatments are safe, effective, and convenient. With newer products and techniques many are lasting significantly longer than previously and some have even replaced more invasive procedures. More involved and generally surgical methods are needed if the problem is excess skin. However, a great deal of aging is from loss of dermal support and volume of fat, muscle, and bone. Both of these are treatable with non-surgical means. Let’s take a look at some of our most popular non-surgical treatment options for a younger, more radiant appearance.

Nonsurgical Facial Enhancement

Facial enhancements are performed both to correct the signs of aging and to bring more symmetry and proportion to the face.

In younger patients, most procedures are to improve inherited traits such as lip asymmetries or size or under eye depressions caused by low attachment of the muscles there. Some nasal problems are also amenable to filler correction.

In older individuals, we usually replace volume loss or treat wrinkles. The former is generally a filler off the shelf such as one of the Juvederm family or your own fat. Fat was initially the method of choice since it is quite long lasting when done properly. However, with the introduction of Radiesse in 2005, which could last several years, and later in 2015 of Juvederm Voluma, which can last many years, fat transfer became less popular. We treat wrinkles initially with Botox to stop the underlying muscles from causing wrinkles if stopping the muscle from functioning has no needed functional deficit. We now treat established wrinkles with the new less dense fillers and methods to stimulate collagen instead of lasers and deep peels.

We all use of these methods Today’s Liquid Lift, a customized treatment developed by Dr. Buchanan after years of performing facelift surgeries. The liquid facelift that he performs is tailored to correct the exact problems that one has with the fastest results and least invasion. This may include various injectables, fat grafting, and Botox as needed to fully refresh and rejuvenate the face with minimal downtime.

Your facial rejuvenation can begin now. Contact our Highlands, NC office at (828) 526-3783 to schedule your visit. earache

The signs of aging are a frustrating concern for many adults. We know certain changes will occur, and we know why. Still, we’d prefer to sidestep them if we can. As facial structure transforms over time, we need more profound correction. Is it possible to achieve this without surgery? It may be! To help patients address their cosmetic concerns, Dr. Buchanan has developed Today’s Liquid Lift™. We’ll discuss how this process works and why it is popular among our patients.

What Is A Liquid Facelift?

Just by the name alone, you can probably guess that a Liquid Facelift utilizes various injectables to correct the signs of aging. Fillers, either off the shelf or your own fat, are injected to improve volume. Botox is used in certain areas to relax muscle contractions that pull on the skin. Today’s Liquid Lift addresses the signs of aging using Botox, hyaluronic acid fillers and fat injections. This technique, developed by Dr. Buchanan to address the aging that naturally occurs after facial plastic surgery, corrects the natural deflation of the face that occurs over time.

Facial aging continues regardless of surgery or fillers and Botox. As it does, the loose skin that results from volume loss droops downward. The opposing actions of sagging skin and supportive ligaments deep beneath the skin result in cosmetic problems like undereye bags and the loss of youthful cheek contour. Nasolabial folds and marionette lines also deepen around the nose and mouth as tissue descends further. Fillers may soften the appearance of these lines but they do not correct the original problem, the loss of volume.

The purpose of Today’s Liquid Lift is to artistically restore the triangular shape of the youthful face. This technique increases the width at the top areas of the face, tapering incrementally to narrow at the jawline and chin. Treatment focuses on restoring volume in the mid-face, across the cheeks. Filling out this area naturally elevates the skin and tissue that have descended downward toward the jawline. Targeting the upper malar area near the tear trough, Dr. Buchanan can also smooth the transition from the cheek to the lower eyelid, camouflaging puffiness.

Experience the benefits of a Liquid Facelift. Contact our Highlands, NC office at Call (828) 526-3783 to schedule your consultation.

Microneedling is one of several technologies that markedly rejuvenates the skin and reduces wrinkling.  Here we will discuss those technologies and other things that you can do to improve the quality and appearance of your skin.

Retinol/Retin-A

The cornerstone of skin care to prevent wrinkles has been, for many years, the use of a retinol or tretinoin (Retin-A) after the age of 30.  This is because the skin stops continually making collagen, the substance that thickens the skin, at around 30 years of age.  If the skin is not stimulated to continue the process of collagen production, the dermis, the support layer of the skin, thins and multiple crinkles and wrinkles result.  If you have failed to use these in the past and have developed significant crinkles and wrinkles, then use of the more potent tretinoin is still the mainstay of skin rejuvenation.

Peels & Laser Resurfacing

Once you had developed aged appearing skin, the only treatment that could correct the wrinkling/crinkling was a leveling peel or laser resurfacing that removed the surface of the skin between the wrinkles to the level of the bottom of the wrinkles and allowed the skin to grow a new surface epithelium over a smoother dermal base.  The problem with this is that, because of limitation of the body’s ability to resurface the skin, they became the procedures with the longest downtime of any of the modern plastic surgical procedures.  Although we could push the body some, the minimum downtime where the skin is somewhat raw and oozing with either of these technologies is about 1 ½ to 2 weeks.

Intradermal Filling

Although fillers have been called “dermal fillers” for many years, until recently no one actually injected the filler into the dermis, the support layer of the skin.  If they did, frequently a greenish or bluish line would appear when light reflected off the injected filler.  Only in the last 10 years have we had fillers that did not cause this blue line, the Tindal effect.  Belotero Balance® introduced in 2011 was the 1^st.  Juvederm Volbella®, equally as good if not better, was approved in 2016.  These allowed us to actually inject fillers into the dermis elevating the surface of the wrinkle to reduce or eliminate it.  We have also discovered that if the product is placed just at the bottom or under the dermis perpendicular to the wrinkles, it can prevent further wrinkling of the skin and allow the tretinoin to use some of the product to thicken and stiffen the skin.  Other than some mild swelling and occasionally minimal bruising that could be covered with camouflage makeup, there is essentially no down time with this technique.

Microneedling/Fraxel Laser

The one thing that leveling peels and laser did was markedly stimulate the dermis to build significant new collagen at a faster rate than it did with just the use of tretinoin.  The 1^st improvement to markedly improve the rate of the skin’s collagen production was development of the Fraxel Laser, a laser that, instead of removing the surface of the skin, simply poked holes in it.  Since injury to the dermis is the one thing that causes the skin to markedly produce collagen, this significantly turned on the body’s healing processes.  This laser, however, is quite expensive and uncomfortable.  Microneedling was developed to answer these problems.  It does the same thing by using small needles that create holes in the dermis and also turns on the body’s healing processes, markedly stimulating collagen production.

The procedure, done in a physician’s office, uses a device that pushes the needles absolutely perpendicular so that there is only a very minute entry point.  Because of the marked success of this process, “Microneedling” rollers are now being sold for home use.  The problem is that they do not produce uniform holes to the proper depth in the dermis and, instead of entering and leaving absolutely perpendicular, they enter and exit at an angle actually tearing the skin.

Who is a Good Candidate for Microneedling?

Because it works by stimulating collagen productionin the dermis, the support layer of the skin, microneedling is an excellent treatment option for a wide variety of concerns. You should be a good candidate for microneedling whether your goal is to correct a cosmetic concern or simply to support your naturally aging skin that stops making collagen naturally around 25 years of age. Microneedling is efficient at reducing enlarged pores, softening lines and wrinkles, and reducing the appearance of scars and stretch marks. Since the skin loses collagen over time  mictoneedling is advantageous in the fight against sun damage and tissue laxity.

What Are the Benefits of Microneedling?

There are several reasons why microneedling is such a popular cosmetic treatment. The process takes only about an hour in most cases and it incurs essentially no downtime. Your skin may look red for a few hours after your treatment, but not so much so that you have to rearrange your schedule for several days. You may return to work or other activities immediately after you’ve had microneedling done. Another benefit of microneedling is that the treatment works naturally to rejuvenate your skin from the inside out. There are no incisions, no products, no “foreign substances.” It does, however, work better if you are on regular tretinoin (Retin-A) or, if you are younger than 45-50, retinol.

How Does Microneedling Work?

Microneedling is a form of collagen induction therapy that has been around far longer than most people realize. Ancient civilizations used this technique, though not in the same fashion we do today. The microneedling treatment that professionals perform is done with an automated instrument rather than a hand held needle or a needle-clad drum. The benefit of this is that the needles pass into the skin in a completely perpendicular pattern and penetrates only a specific depth. This significantly reduces the risk of tiny skin tears and the potential for scarring. During a microneedling session, the automated device quickly creates hundreds of micro-injuries in the dermis of your skin. Micro-injuries take very little time to heal. Their sole purpose is to trick the body into believing repair is needed. Repair comes in the form of increased collagen and elastin production, which the body makes for a prolonged period of time in response to the treatment. The increase in the body’s regenerative system works to rejuvenate the skin.

When Will I See Results from Microneedling?

You might notice some of your microneedling results the same day you have your treatment! Many people report feeling like their skin has a new vibrancy to it right after their appointment. This early improvement expands into others as your body begins to flood the treatment area with an ongoing supply of collagen and elastin. The results of a single treatment occur over time with multiple sessions being cummulative. If you are trying to reduce significant wrinkling, however, it may take a year or more to see the final results/

Is any Numbing Cream Applied Before?

Yes! Comfort is an important aspect of our treatment process. To minimize the sensation of this process, we’ll apply a topical anesthetic to the target area. This medication does not cause complete numbness like injections of lidocaine do. However, it achieves sufficient desensitization to make microneedling easily tolerable.

Can I Combine Microneedling with Other Treatments?

You can combine microneedling with other treatments to acheive more profound tissue rejuvenation. As previously said, we recommend everyone receiving microneedling be on either retinol or tretinoin. For significant wrinkling in the past we used leveling peels or ablative lasers. Their problem is that they have a 2-3 week down time. Instead, we now use microneedling after filling the worst wrinkles with one of the newer fillers that works well when injected in the dermis itself. (Although many people call them “dermal fillers,” we previously never actually injected the dermis with them since the old fillers caused a blue or green line, the tyndall effect.) We will discuss what you’d like to achieve and what concerns you have and will recommend a treatment plan using that information. To get the best results with the fewest risks and side effects, microneedling may be scheduled as a standalone procedure within your broader course of treatment.

No Downtime Skin Rejuvenation

These latter two developments have allowed us to now achieve skin rejuvenation comparable to leveling peels and laser but without the significant downtime.  Our present protocol for rejuvenation of sun damaged, wrinkled, crinkled skin is beginning tretinoin, injection of the wrinkles to reduce as much as we can using Volbella®, and then doing a series of Microneedling procedures, all with minimal to no downtime.

If you are interested in rejuvenating your skin, schedule a consultation with Dr. Buchanan at our Highlands, NC office. Call (828) 526-3783 today.

Recently, we’ve seen the meteoric rise in filler use among adults of all ages. Soft tissue fillers like those in the Juvéderm family are known for achieving consistent results whether the goal is to smooth wrinkles and folds or plump areas of the face that have lost their volume and normal contour. The cheeks and area below the eyes are prime areas where this happens, and treatment using Juvéderm Voluma XC is one of the best ways to correct these problems.

What is Juvéderm Voluma?

Several products make up the Juvéderm family of fillers. All of them are made of varying compilations and consistencies of hyaluronic acid (HA). This chemical is a naturally-occurring sugar compound that the body uses to keep the skin, joints, and eyes lubricated and to produce new collagen, which thickens the skin and supports the surrounding tissues. The Juvéderm products also contain lidocaine, an anesthetic that reduces discomfort during injections. Juvéderm Voluma has been developed with a heavier consistency to achieve specific results. There is, in fact, only one other filler nearly as thick as Voluma.

Having a denser consistency, Voluma XC can build more structure beneath the skin. The name of the product, Voluma, indicates its purpose, to restore structural volume of the tissues. This filler was the first to be FDA-approved for cheek enhancement. As we age, this part of the face loses its shape. The fat pads that overlay the cheekbones and make them look more pronounced decrease in volume over time. As the face loses volume, the tissues descended as far as the next ligament and folds resultat teh ligament and depressions occur above. By midlife, the mid-face looks rather flat and, as a result, the lower face looks wider, fuller and saggy. Occasionally a similar appearance occurs from congenital anatomic variations and younger individuals look older than their actual age. When Voluma XC is placed on the bony of the cheek, it elevates, rounds, and firms the overlying tissues.

What to Expect During and After Voluma Treatment

Filler treatments are very popular but that does not make them right for everyone. We conduct a consultation and brief assessment of the skin, underlying muscle and bone structure, and facial volume to make sure that an injectable can achieve the desired outcome. The treatment itself takes only a few minutes. Injection is done using a very thin cannula through the absolute minimum of skin punctures. The Voluma is carefully placed on the underlying bone under where extra volume is needed. This technique not only is safer than use of a sharp needle, it is more controlled and gives superior results. Thanks to the lidocaine and tiny cannula, there is minimal discomfort.

Results are visible as soon as the Voluma treatment is complete,. You may experience short-lived firmness and swelling for a day or so. Except occasionally at the point of entry through the skin, there is almost never any bruising. To reduce the risk of bruising further you should avoid strenuous exercise for the first 8 hours after injections.

We can help if you have a congenital volume deficit or believe you are aging. Call our Highlands, NC office at (828) 526-3783 to explore what Juvéderm Voluma can do for you.

Science hasn’t yet pinpointed a way for us to bypass the signs of aging. It has, however, given us numerous techniques and technologies that help us manage the cosmetic effects of getting older. Many of the problems we have as we age have to do with the loss of the support of the skin, either the dermal portion of the skin or the underlying fat or bone. This knowledge has led to the development of several soft tissue fillers, many of them contained within the Juvéderm family of fillers.

The Juvéderm product line of fillers are all cross linked hyaluronic acid. This naturally-occurring chemical is the basis of collagen that is the support layer of the skin and the deeper support structures. Normal hyaluronic acid particles absorb water molecules  and hold them in place for an extended period. The crosslinking, however, can modify this characteristic. Here, we explain what sets the various Juvéderm fillers apart.

JUVÉDERM ULTRA XC

Ultra XC was one of the first hyaluronic fillers developed. It and Ultra Plus XC (a heavier product that I do not use now) are the only fillers in the Juvéderm line that absorb and hold onto significant water. This allows us to get more fill than the specific amount injected. It is frequently used to give more volume to the lips and other superficial soft tissue areas. Here, it is soft enough to feel natural and dense enough to increase fullness.

JUVÉDERM VOLBELLA XC

Volbella is a Juvéderm filler that has been developed specifically for lip enhancement. Why would the maker do this when they already have ULTRA XC to add volume to the lips? Because some people don’t want such a substantial volume increase or just need a little finesse to the area. Also, because the mouth is a delicate area that can develop ultra-fine lines around the edges. Volbella is a lighter-weight filler and, thanks to Vycross technology, does not absorb water. It is ideal for mild augmentation and adding subtle definition to the borders of the lips. It also is excellent for filling fine lines and providing support just under the skin opposite to the wrinkle direction to stiffen the skin and provide a matrix that the body can use to make new collagen. These are things you cannot do with Ultra.

JUVÉDERM VOLUMA XC

Voluma is aptly named for its primary objective. This filler is the first, and really the only, of its kind in the hyaluronic acid realm. It is also Vycross technology, which makes it excellent for use around the eyes where water absorption can cause problems. It’s density and molecular structure are intended for deeper insertion near the bone or in the deeper subcutaneous layer. This allows contouring, particular in the cheek area, correcting flattening or a sunken appearance. Voluma is specifically indicated tor tear trough correction of under eye bags. It is, in fact, the safest filler for this purpose, and use of any other hyaluronic acid filler is now considered inappropriate except for very specific exceptions.

JUVÉDERM VOLLURE XC

Like ULTRA XC, Vollure is soft enough that it is excellent for the lips and other soft tissue areas, but is heavy enough to support the cheeks where it can be molded and also retain flexibility during facial expressions.

The Center for Plastic Surgery in Highlands, NC is dedicated to the most conservative, minimally-invasive treatments. We use the different Juvéderm products depending on the specific problem as a part of this, what we call Today’s Liquid Lift.  To see if these products can help you or to learn more about Juvéderm and their use with other non surgical treatments, call (828) 526-3783.

We hear this question quite often. “Will one treatment be enough to achieve results?” Unless your cosmetic objectives can be met with a surgical procedure alone, this is an unlikely accomplishment. Even in the case of injectables and soft tissue fillers, which do achieve immediate results, improvements require maintenance every year or so.

To understand the role of professional treatments in ongoing beauty at every age, it can help to think of the skin the same way you do the body. Your skin needs to be “fed” quality products every day to rebuild itself just like your body relies on healthy foods to maintain vitality. Similarly, as much as we would like it to be true, we cannot work out one time and develop six-pack abs. Just like we won’t slim down after one healthy meal or strenuous workout, our skin will not look many years younger after one nonsurgical treatment.

One Way to Feed the Skin

In reality, there are several ways to feed the skin, but there is one objective that may trump all others: collagen and elastin production. By age 30, fibroblasts, the cells that produce collagen and elastin, begin to slow down. Not just a little, but a lot. Some studies suggest that fibroblasts go dormant, into a state of sweet slumber that allows the signs of aging to creep in. With the body wearing out its existing supply of collagen and elastin at a rate of about 1 to 2% a year, we typically see noticeable changes in the skin by age 40 and continually for the rest of our life. The key to managing aging skin, then, is to encourage the fibroblast cells to continually produce more collagen and elastin.

Professional treatments like fillers correct the signs of aging, which is certainly advantageous. However, injectables alone are not enough to effectively manage the signs of aging. By that, we mean to keep them from worsening. To do this, we recommend adding retinol or Retin-A and ELASTIderm to basic skin care starting around age 30.  The retinol or Retin-A (tretinoin) stimulates new collagen. The ELASTIderm by Obagi is the only product on the market that stimulates conversion of some of that collagen to elastic tissue. Other periodic collagen-inducing treatments like micro needling, actual dermal or just sub-dermal injection of the proper hyaluronic acid filler, peels or laser skin resurfacing can also help. Depending on where you are on the spectrum of collagen degradation, you may need one treatment a year, several treatments a year, or one treatment every few years.

If you are interested in reversing and managing the signs of aging, come talk with us. We may not be able to promise a one and done treatment for every concern, but we can promise that we are committed to long-term results and personal care for each of our patients.

Call (828) 526-3783 to schedule your visit to our Highlands, NC medical spa and plastic surgery office.

There are several benefits of getting fillers injected in one or more areas of the face. This nonsurgical treatment is sought by younger patients who wish to enhance the shape of their lips or cheeks and by older adults who would like to reverse many of the changes of aging. Fillers are even used to improve the appearance of the nose and are an integral aspect of the nonsurgical facelift. Still, there is a very real chance that you could be let down by your treatment. There are several reason this happens.One is that there are a huge number of injectors with little or inadequate training. Another is that patients rarely know how much filler they need to achieve their desired result, but attempt to dictate how much filler is used.

How much is enough?

Several factors contribute to the outcome of filler treatment. For this reason, it can be difficult to estimate just how much filler one person will need compared to another. For example, some people visit their provider with an idea that they need 1 syringe of filler to correct the flattening of their cheeks. They believe this because their friend obtained amazing results with just that much. After receiving their 1 syringe, the patient may feel dissatisfied that their cheeks don’t look like their friend’s. Why might this be?

• Fillers don’t affect everyone the same way. This is because each person has unique bone and muscle structure. Even side-sleeping can affect how the face looks on one side versus the other. These small details contribute to the outcome of filler treatment and also determine, to some degree, how much filler is needed by each person.
• The amount of volume loss (of both fatty tissue and bone) will also impact how much filler is needed to plump the area.
• The area that needs filling also partially determines how much filler is required.

Expectations are Everything

One of the most significant factors that translates into patient satisfaction is expectation. It is important to approach filler treatment with an open mind about what is and is not possible:

• Fillers can, occasionally, make you look 10 years younger, but only in certain circumstances. If done improperly, they can also make you look older.
• Filler treatment can round out cheeks and plump lips, but it will not tighten loose skin. In some cases, a slight lifting effect may occur, but this is not guaranteed.
• Results may last longer for some people. This is a matter of simple biology and how quickly the body will metabolize the inserted product.

See what fillers can do for you. Schedule an appointment to learn more in our Highlands, NC office at (828) 526-3783.

You may have heard of the term “double-chin.” This common problem affects adults of all ages. Because a a large number of double chins are made up of fatty tissue, this cosmetic condition often gives the impression that a person is overweight. The truth is, the neck under the chin is just another area in which many people wish they could spot reduce fat. It’s a part of the body on which fat cells may simply accumulate for no good reason. Statistics suggest that nearly 70% of American adults are troubled by submental fullness. Clearly, this is a problem for which reliable solutions are needed. We have them.

Treatment Options for a Double Chin

There are a handful of treatment options that can reduce excess fat under the jawline. However not every technique is ideal. In our Highlands, NC office, patients receive options that are proven to achieve the best results in the shortest amount of time. These are liposuction and neck lift surgery.

Neck Liposuction

With nonsurgical treatments like Kybella, why would anyone undergo surgery anymore? The answer is simple: reliability, fast recovery, and results. Neck liposuction is ideal for several reasons. First, the results from treatment are almost immediate. Due to the minimally-invasive nature of neck liposuction, Dr. Buchanan performs this procedure in the office using a local anesthetic. We understand that may sound uncomfortable. It’s not. Patients who undergo neck liposuction with local anesthetic and a mild sedative typically have one response: “Wow! That was easy!” Kybella typically takes more than one treatment, is more uncomfortable that liposuction and the recovery from the first treatment is longer than liposuction.

Neck liposuction removes the localized fat cells beneath the chin and jawline to reveal a more dramatic curve from the upper neck to the face. Treatment usually takes about an hour, after which a compression garment may be worn for a short while when alone. Within a few days, patients are back to normal activities.

Neck Lift

It is important to know what your skin is capable of as you seek treatment for submental fullness. Even many of the nonsurgical treatments that are popular today focus only on fat destruction. If your skin has lost elasticity, it won’t bounce back after fat is removed, no matter the method of removing the fat. Without proper retraction, the skin may look worse without the smoothing effect of the unwanted fat. For this reason, some patients are better served by a neck lift.

Like neck liposuction, the neck lift can also be performed in the office with a local anesthetic with or without sedation. The procedure involves an incision under the chino vertically in the central neck. The neck muscles are carefully released and tightened with sutures. The skin is repositioned, as well, and, with some procedures, excess is trimmed before the incisions are closed. Recovery time after a neck lift is about one to two weeks before most normal activities can be resumed.

Zerona Fat Reduction

Although Zerona is better at treating larger areas, if you have some larger areas that you wish treated, the neck can be treated at the same time using Zerona non invasive laser fat reduction.

What to Know About Kybella Double Chin Treatment

Kybella is one of the most commonly hyped and discussed double-chin treatments today. The technique is safe and it is effective. However, so are the neck liposuction and neck lift procedures. Although it is claimed there is no downtime with Kybella, after treatment there is noticeable swelling that may prevent normal activities for a few days and is generally worse than liposuction and lasts longer. Also, to get liposuction-like results with Kybella, it is necessary to undergo up to 4 treatment sessions (each with multiple injections) and several months of waiting for fat to naturally dissolve. Although it was initially thought that the reaction from the Kybella would tighten loose skin, experience haas shown that this does not happen.

If you’re interested in prompt results from chin-sculpting treatment, call our Highlands office at (828) 526-3783. During your consultation, we can provide details about sculpting procedures that are right for you.