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Are You Wondering Why Juvéderm Has So Many Options?

Are You Wondering Why Juvéderm Has So Many Options?

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.

One and Done Beauty: Is it Possible?

Non Surgical Procedures Highlands, NCWe 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.

What is the Right Amount of Filler for Me?

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.

The Way to a More Sculpted Jawline

 Neck Lift | Highlands, NCYou 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.

Where is the Lip Trend Now?

Lip Enhancement Highlands, NCIn recent years, we witnessed a tremendous increase in appreciation for full, pouty lips. People everywhere sought to create their very own Angelina Jolie or Kylie Jenner look. As social media posts went viral with Jenner’s famous lips, in particular, lip enhancement procedures soared. However, about this time last summer, Kylie’s lips took a major turn. The star shocked fans by having her lip fillers dissolved. Seeing that trends are influenced by popular celebrities, many people assumed that the whole lip filler trend would disappear. Has it?

The End of a Look isn’t the End of an Era

Kylie Jenner has been one of several celebrities to openly discuss her use of fillers or other treatments. Her change of heart about what had been her signature look for a few years took the world by surprise. However, that choice is not an indication of the wider trends in beauty. Instead of tossing aside the idea of fuller lips, what we’re seeing patients do today is strive for fullness without the pout. This trend mirrors that of other plastic surgery transformations, including more natural breast augmentation and subtle facial rejuvenation procedures. As many cosmetic procedures were originally intended, patients now agree more with the concept of looking like themselves, only better.

What Does All This Mean for Lip Fillers?

The end of the Kylie Jenner lip era has not had a huge impact on the lip filler market. Primarily, what has changed is technique. Hyaluronic acid products like Juvéderm Vollure continue to be incredibly popular. Patients still appreciate the instant results they can get from injectable lip enhancement, not to mention the natural-looking outcome.

Lip enhancement, though made more popular by celebs like Jenner, is not conducted only to achieve a luscious pouty mouth. Many of our patients who express interest in lip enhancement do so out of concern for the way their lips have changed with age. Naturally thin lips can all-but disappear as they lose what little volume they had. Fuller lips deflate as collagen and elastin break down in the skin. These are common concerns that can be immediately corrected with fillers.

The results of lip enhancement can make a big difference in a person’s life. A skilled provider can make small adjustments to particular parts of the lips to make a big impact on appearance. For example, a small amount of filler into the top lips can accentuate and shape the perfect “cupid’s bow.” Injections at the lip line can recreate subtle fullness that makes the lips look younger. Filling the lower lip can restore its normal proportion and eliminate lipstick bleed.

Schedule your Consultation

Lip enhancement treatment isn’t going anywhere because aging is continuous. To schedule your consultation for natural, younger-looking lips, call our Highlands, NC office at (828) 526-3783.

A Facial Refresher Without Surgery

The signs of aging create concern for many adults. As tissue loses firmness and resiliency, lines on the forehead and around the eyes, nose, and mouth worsen. In time, the changes in facial structure need to be addressed in more profound ways. Historically, the way to restore a more youthful appearance has been to undergo facelift surgery. When we hear the term facelift, it is surgery that comes to mind for most people. Today, we have another non-surgical option to consider. For patients of our Highlands, NC office, that option is Today’s Liquid Lift™.

What Is A Liquid Facelift?

A liquid facelift is a nonsurgical, minimally-invasive procedure for revitalizing the face. Treatment involves the strategic use of fillers to correct volume loss, one of the most common signs of aging. The Liquid Facelift has been around for many years now and has been refined by experienced physicians like Dr. Buchanan. Where the many Liquid Facelifts typically includes fillers only, our technique incorporates Botox and fat injections as needed to achieve optimal results.

Dr. Buchanan developed Today’s Liquid Lift in response to seeing many patients encounter re-aging after an initial facelift. Many of the patients who visit a plastic surgeon have no dramatic signs of aging on the neck to address but have a desire to restore more youthful contours to the face. Surgery may not be the ideal solution to achieve this objective. This is especially true since many of the surgical methods used by many physicians actually further thin the face.

Today’s Liquid Lift addresses the signs of aging that result from natural deflation in subcutaneous tissue. As volume is lost in the mid face, cheek or under the eyes, the now loose skin and tissue descend downward. They are stopped by ligaments attached deep resulting in a depression under the ligament and fullness above it. This creates under eye bags, depressions in the cheek with loss of the youthful cheek curve, and nasolabial and marionette folds around the nose and mouth. In the past, nasolabial folds were treated as an individual problem. Filling these creases with fillers may soften their appearance but it does nothing for the original problem. By neglecting the deflated tissue in the malar and cheek areas, there is a potential to increase the squareness of the face and actually worsen the appearance of aging.

A youthful face is triangular. There is more width near the top of the face, transitioning into a narrow jawline and chin. Today’s Liquid Lift restores volume in the malar area (the mid-face). In so doing, this technique naturally elevates the tissue that has begun to droop. Filing over the malar bone below the orbital rim also refreshes the face by smoothing the transition of skin between the upper cheek and the lower eyelid. This technique camouflages puffiness without the risk of swelling in the tear trough area.

Experience the Benefits of a Liquid Facelift

A Liquid Facelift is advantageous for several reasons. It is nonsurgical, convenient, incurs no downtime, and achieves good results. Today’s Liquid Lift offers all of these benefits and more thanks to refined techniques.

Learn more about nonsurgical facial rejuvenation. Call (828) 526-3783 to schedule your consultation.

Treating Facial Skin Wrinkles

Wrinkled or crepey facial skin is caused by an interplay of the skin and how it ages, gravity, loss of supporting volume, and action of the underlying muscles. As we age, the skin stops producing both collagen (the substance that gives the skin its thickness and strength) and elastin (the substance that makes the skin elastic). This happens around 30 years of age with collagen only being made after that as part of healing. With both collagen and elastin present, the skin contracts and then, because of its thickness, resists further muscle pull. With the loss of them, the skin does not contract and the muscle pulls the skin further than normal and causes it to pleat. With time, the muscles also hypertrophy and pull even harder and the places where the skin tends to bend become permanent lines. How much the skin crinkles or wrinkles varies due to your genetic predisposition and how you have treated your skin. Smoking, diet and other environmental factors speed the process. There are, however, several things that can be done to improve or reverse this.
 

Use of Botox®

If the muscle can be weakened with Botox® or a similar neurotoxin, the process can be slowed. This works best around the eyes and in the forehead where the muscle function is not essential. If started early, it can even slow the creation of wrinkles.
 

Improving the Quality of the Skin:

You can also slow the process and even reverse it by adding collagen and elastic tissue to the skin. Collagen can be added by use of tretinoin (Retin-A) or good retinol or by microneedling or similar laser procedures. We prefer tretinoin or retinol regularly as it continually stimulates collagen production, is less invasive and, we think, more reliable. Elastin can be added by use of Obagi’s ELASTIderm®, the only product proven to do this. We generally add these to Basic Skin Care at about 30 years of age when the skin stops producing collagen and elastin without some encouragement.
 

Reversing Wrinkles:

If the wrinkles are minimal or small, the above options will reverse them, but it takes about a year or so to do so. There are 2 things you can do to improve the wrinkles faster. One is laser resurfacing or a leveling peel that brings the surface of the skin down to the level of the bottom of the wrinkles and stimulates significant collagen production. Both these, however, have a prolonged recovery. The other is to fill the lines or depressions with a filler like Juvederm® Volbella and then crisscross it under the skin to stiffen it. This also helps the tretinoin work since it can increase the body’s use of the hyaluronic acid from the filler to convert it to collagen (something that is now proven to happen). Fillers are also the answer if the wrinkles are due to volume loss as they fill deep, replacing the lost volume, and stretch the skin back, flattening many of the wrinkles. This is especially true with lip wrinkles. The recovery from this is minimal with only a little swelling and, occasionally, some bruising that is easily camouflaged.

To find out more or to determine what is right for you, call 828-526-3783 to make an appointment at our Highlands office.

Fillers or Blepharoplasty: What is the Best Option for You?

Blepharoplasty Highlands, NCThe eye area is a point of concern for many adults. Several different problems under the eyes can cause frustrating problems, such as puffy bags, lines or dark circles. These can be caused by the stretching of the eyelid skin, descent of the tissues or loss of supporting tissues. You may have heard of filler treatment for under-eye problems like these and that there is a surgical procedure, lower blepharoplasty, that can improve the appearance of the under-eye. Both provide an excellent opportunity for a younger, fresher looking face, but it is likely that one is a better option for you based on your desired outcome, what caused the problem and your preferences. Here, we discuss details of blepharoplasty and fillers to set you on your best path.

Procedural Similarities and Differences

Blepharoplasty is an eyelid surgery that is performed as an outpatient procedure. It is best for those who have too much skin in the under-eye. In most cases, unless cheek elevation also needs to be done, the procedure can be done in the office with local anesthesia. Our blepharoplasty techniques are conservative, focusing on removing excess and repositioning tissue to achieve an excellent, long-lasting contour beneath the eyes. Lower blepharoplasty surgery can take anywhere from an hour to several hours, depending on the degree of change needed to achieve the desired outcome. Recovery is rapid. Sutures are removed in 3-5 days and most swelling and bruising resolve in 10 days to 2 weeks. You can resume most activities in several days.

Filler treatment is done in the office and can be done with local anesthetic if needed or a topical numbing cream can be applied to the skin. The treatment itself usually takes less than an hour, and all fillers we use contain a numbing medication so any sensation is minimized. They are ideal for those who have simply lost volume and have minimal excess skin. A filler below the tear trough at the upper cheek can restore volume to the area and diminish the appearance of both hollowness and puffiness. By smoothing the area, shadows and highlights are eliminated reducing “dark circles.” You do not need to take time off work or social obligations to recover from filler treatment. If, instead of an off the shelf filler, you opt for fat grafting, recovery is almost the same.

In some people, a combination of treatment may be the most reasonable. In fact, we have stopped doing cheek lifts and, instead, combine Blepharoplasty and filler or fat grafting.

The results of blepharoplasty last years. The eyes will always look younger than they would have had a blepharoplasty never been performed. However, the area will continue to age over time and further treatment may be desired again in the future. Fillers, on the other hand, are partially absorbed naturally by the body over time. This means that some of the filler is permanent having been used by the body to create new collagen, the building block of the tissues. Because the filler we use for eyelid rejuvenation is the longest lasting one available, it lasts minimally two years and has lasted significantly longer, in one case, well over 4 years.

There are pros and cons to both forms of eyelid rejuvenation and each has a specific problem where it is ideal. For further information and to find out whether fillers or blepharoplasty would be best for you, call our Highlands office at (828) 526-3783.

How to Take Care of Your Newly Refined Lips

 JUVÉDERM VOLUMA™ XC in Highlands, NCIf there’s one cosmetic trend that’s taking the industry by storm, it’s lip rejuvenation. Here at The Center For Plastic Surgery, we use Juvederm Vollure, Ultra, and Volbella to help add more volume and contour lips while also eliminating any lines around your mouth in the process. This is done with each person’s age and desires in mind. Our general goal is to create natural lips consistent with one’s age unless you wish otherwise. After you get your Juvederm injections from our office, we have a few other tips that you can use to help take better care of your improved lips.

Keep Them Hydrated & Protected from the Sun

Having great looking lips can suddenly turn into something less than sexy if you aren’t keeping them hydrated. Make sure that you consistently use a hydrating lip balm that also protects them from the sun with clear zinc oxide. We recommend Jane Iredale lipsticks or her Lip Drink.

Get Regular Injections

The great news about lip injections is that they don’t require a lot of upkeep and work. On average, the different Juvederm products used for the lips last between 10 to 21 months, though most people retain at least 10% of what was injected permanently. This means you do not need as much injected on each succeeding injection to achieve the same result as before. To really keep your lips looking great, make sure that you schedule regular and consistent treatments at our office. If you want, once you know how long the injections last in you, we can schedule your next appointment far in advance so that you don’t miss a beat.

Are you ready to learn more about lip injections and whether or not they’re right for you? Schedule your consultation at our Highlands office today or call us at (828) 526-3783.

Give Yourself a “Hand”

Consider your hands. Think of all the things they have accomplished over the course of your life: The meals prepared, the love given, the dishes washed, the diapers changed, the letters written and the flowers planted. Your hands have worked hard and are one of the first places to show the visible signs of aging. With time, you may begin to see darkened “age spots” or a loss of fatty tissue which makes your hands look bony and perhaps older than your age.

hand careHand rejuvenation treatments can reverse the visible signs of aging, including the effects of sun damage and can help restore your hands to a more youthful appearance – one that matches your youthful, active lifestyle. Various treatments are available and treatment options may be combined to help you achieve the look you desire.

Here are four ways Dr. Buchanan can treat your aging hands at The Center For Plastic Surgery:

  1. Laser Like Skin Rejuvenation – The Ellipse IPL® offers the advantages of intense pulsed light therapy, a proven technology that treats the red and brown areas of sun damage using short bursts of laser like light which penetrate and gently remove “age spots.”
  2. Chemical Peel – The Obagi® RADIANCE Peel is a salicylic acid peel that can improve the look, texture and feel of your hands in minutes with no down time. Glycolic fruit acid peels remove the dry, top layer of the skin to reveal healthier, moist skin underneath.
  3. Microdermabrasion – This is a superficial skin polishing that “sands” off the first layer of the skin with tiny crystals. The procedure is non-surgical, non-invasive, fast and easy.
  4. Injectables – When injected, fillers such as Juvederm injectable gels or your own fat plump the skin on your hands to give them a more youthful appearance by somewhat hiding the veins, bones and tendons.

As with any cosmetic procedure, it’s important to have realistic expectations and keep in mind that these procedures are designed for improvement, not perfection.

If you would like to know more, call 828-526-3783 for a consultation with Dr. Buchanan, today, and enjoy younger looking hands.

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