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209 Hospital Dr #202
Highlands, NC 28741

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Blepharoplasty: An Eye-Opening Experience

Blepharoplasty: An Eye-Opening Experience

It is said that the eyes are the windows to the soul. Research suggests that when we look at people’s faces, it is their eyes that we notice first. This could be because we “read” the eyes to discern others’ character and mood. It is also our eyes that others first see. We are quick to notice the signs of aging in this area of the face. Concerns such as under-eye depressions, dark circles, and hooded upper eyelids are hard to miss. They are not hard to fix, though. Patients of Dr. Buchanan can experience eye-opening benefits with blepharoplasty eyelid rejuvenation surgery.

What is Blepharoplasty?

Blepharoplasty is the term used to describe the surgical reconstruction or remodeling of either the upper or lower eyelids or both. Most blepharoplasty procedures are performed to improve the appearance of the area. However, they can sometimes be medically necessary. For example, some people need upper blepharoplasty to remove excess skin or to shorten the muscle that elevates the lid when either causes obstruction of their vision. The upper blepharoplasty procedure is done through small incisions along the natural crease of the eyelid. Excess skin and, occasionally, fat are trimmed. The muscle can also be shortened, the brow tacked up, or the muscles between the eyebrows removed through the same incision. We do the procedure in the office in about 1.5 to 2 hours, after which you go home to recover. Lower blepharoplasty takes a little longer through incisions hidden just below the eyelid margin. Patients are comfortable throughout their procedure with light anxiolysis if needed and a local anesthetic that numbs the area.

Post Blepharoplasty Care

After blepharoplasty, patients can usually control discomfort using an over-the-counter medication like Tylenol. However, a mild prescription pain reliever can be ordered if necessary. The first follow-up visit is usually at 3 to 5 days after the procedure. At this visit, small external stitches are removed. By this visit, much of the swelling that had occurred after surgery is resolving. Bruising may disappear more gradually but can usually be disguised with makeup. We usually also give medication to start before the blepharoplasty to help reduce bruising and hasten its absorption.

There are several reasons why blepharoplasty is one of the leading plastic surgery procedures performed today. Dr. Buchanan provides this service in the comfort of our Highlands, NC office, where patients are in experienced hands for an eye-opening process of facial rejuvenation.

Would you like to look more refreshed? Contact us at (828) 526-3783 to schedule your blepharoplasty consultation.

How to Make Your Skincare More Effective

“Skin care” is a term that we use in two ways. We use it to describe the products that we apply to cleanse and treat the skin, and also to describe the act of caring for the skin. Because the term is interchangeable, there is a risk of blurring the lines between the two. People who wash their face and apply moisturizer or a serum or two often believe that this is sufficient effort to get the results they want. It’s not. Here, we discuss the common mistakes that people make with skin care and what needs to be done instead.

Mistake Number One

The most common mistake that people make in caring for their skin is not knowing exactly what their skin even needs. This is no fault of their own. Manufacturers of mass-produced cleansers, moisturizers, and specialty products are savvy about promoting the benefits of their items without acknowledging the lack of clinical efficacy or even making them seem efficacious when they are not. The only way to get clinical results from products is to use medical-grade products that have been picked out for your unique cosmetic and dermatologic needs by a medical professional.

Mistake Number Two

In addition to choosing products based on the marketing seen on television and in magazines or what your mother or grandmother told you, what many people mistakenly do is use those products routinely for months or years on end. The problem with this approach is that most of what is sold either does not do what the skin needs or actually does more harm than good.If professional treatments are utilized, they are usually chosen without any thought of how they fit one’s total skin care needs.

We Can Help You Correct These Mistakes

We divide ski care into Basic, Basic Plus, and Rejuvenative. Basic is what everyone needs, no matter their age, essentially from birth. It consists of a cleanser, a pH balancer (cleansing disturbs the normal pH, which causes the skin not to function well for a while), and a good practical sun block (we prefer clear zinc oxide). The pH balancer can be a simple acidic toner or an acidic serum, like Vitamin-C or something similar, depending on your other needs. Once a teenager, an alpha hydroxy product to remove thickened outer dead cells is added to Basic Skin Care. Professional treatments like chemical peels and microdermabrasion are inexpensive, convenient, and comfortable and can help remove built-up dirt, oil, bacteria, and dead skin cells.

The body stops continually making new collagen to thicken the dermis, the support layer of the skin, and elastin that provides the skin its elasticity around 30 years of age. Therefore, Basic Plus adds retinol or Retin-A to continue the skin making collagen and Obagi’s ELASTIderm to stimulate elastin somewhere around 30 years of age. Although there are thousands of products available, this is all most people need, unless they have significant damage from the sun or other insults.

With problems, modifying skin care to address the specific problem is all most people will need. However, it takes an expert in skin care and rejuvenation to determine what will work best with the least effort and expense.

At the Center for Plastic Surgery in Highlands, NC, we help patients manage their skin in ways that get results. We use only medical-grade products products that have been proven to achieve results. We also have professional treatments like peels, microdermabrasion, IPL light treatments, and laser resurfacing to provide a full spectrum of care.

Get the help you need to keep your skin resilient through the aging process. Call  (828) 526-3783.

What to Expect After Your Brow Lift

Brow lift surgery, often called a forehead lift, is a common outpatient procedure that can have a profoundly positive effect on the face. This technique focuses on raising the eyebrows to a symmetrical, youthful position and arch over the eyes. By lifting the tissue on the upper region of the face, the procedure corrects problems such as heavy upper eyelids, deep wrinkles on the forehead, prominent creases at the outer edges of the eyes, and a generally tired or angry-looking expression.

Knowing that a brow lift can refresh your appearance is one thing. Knowing that you feel ready to undergo this procedure is something else entirely. What stops many people from taking the next step toward greater satisfaction with their appearance is thinking that modern brow lifts are like the old ones with long incisions and a long recovery. Here, we discuss what you might expect after having a brow lift performed in our Highlands, NC office.

Brow Lift Recovery Timeline

Days 1-3

Previous brow lifts were under anesthesia. Dr. Buchanan’s techniques have been refined such that he performs this procedure with local anesthesia alone. Patients are completely comfortable. The first few days after a brow lift, patients can expect to feel slight soreness that is usually managed with only Tylenol. The incisions may also itch for a few days up to two weeks. Sleeping with the head elevated for a few days helps minimize swelling and speeds recovery.There are usually no bandages. You can resume showering with coolish water or bathing immediately, with care.

Days 4-10

Bruising occurs only from the eyes down and is easily covered with camouflage make-up. By the end of the first week, a great deal of improvement in bruising and swelling usually occurs. Stitches are removed at 4-7 days.  You can return to work and other light activities by day 4-5.

Weeks 2-3

As swelling subsides and tissue settles, the brows may look slightly exaggerated in terms of their height on the forehead. Over the next few weeks, the tissue will loosen slightly and the brows will drop into their intended position over the eyes. With the decrease in swelling and bruising and almost complete healing of incisions comes the freedom to return to normal activities, including strenuous exercise.

Weeks 4 to 6

This is the home stretch of recovery when the final cosmetic results become fully visible.

A brow lift can do a lot for the face. See what this procedure can do for you. Call (828) 526-3783 to schedule a visit with our friendly team.

How Blepharoplasty and Brow Lift Surgeries Differ

Eye vs Eyebrow LiftMost people realize that their skin will change as they get older. What comes as a surprise are what causes some of these changes and the underlying and surrounding structures’ contributions to them. These are caused by stretch of the skin and underlying support and descent caused by gravity. They can cause drooping and fullness of the upper eyelid in several ways.

Heavy and droopy upper eyelids are frustrating. Many people visit their plastic surgeon to explore how they can correct this sign of aging. The common options are to lift the upper eyelids directly using the blepharoplasty technique or to lift the upper eyelids indirectly using the brow lift technique. Because each technique can improve the appearance of the eyes, they may be confused as being the same thing. They’re not and, in fact, both may be required to achieve your desired improvement. Here, we discuss how blepharoplasty and brow lift surgery are different.

Eyelid Surgery

Eyelid rejuvenation with blepharoplasty addresses the upper eyelid that has become droopy with sagging skin, excess fat, and/or loose muscle. Often, all three are part of the problem. To improve the appearance of the eyes, blepharoplasty removes excess skin to restore the visibility of the natural crease and smooth roll around the orbital bone. When necessary, excess muscle is also trimmed. On rare occasions, excess fat is removed, usually from medially. This is because that, in the past, fat removal has resulted in greater cosmetic problem than before surgery, usually several years after the surgery. Experienced surgeons, therefore, rarely ever remove any fat.

Brow Lift

The brow lift technique is also called a forehead lift. Dr. Buchanan performs this procedure through small, hidden incisions. Beneath the skin, the muscle and skin of the eyebrows are lifted and secured in a position that stabilizes the eyebrows above the upper orbital rim. If all the tissue excess in the upper eyelid area is from the brow, this is all that is required.

Understanding the Differences and How They Apply to You

We could use the analogy of drooping eyelids being like a pair of pants whose legs pool on the floor. The pants may droop because they are too long, or they may droop because their belt does not hold them up at the waist or both. Eyelids that are too long due to excess skin and muscle laxity can be refreshed with blepharoplasty. Eyelids that are not being held well by the tissue and muscles of the forehead require a brow lift for correction. In some cases, a combination of the two is the ideal approach.

Both blepharoplasty and brow lift surgery may be performed without general anesthesia in the office. The use of minimally-invasive techniques also reduces downtime and speeds recovery. To learn more about these procedures, call (828) 526-3783 and schedule a consultation in our Highlands, NC office.

Are You a Good Candidate for Eyelid Surgery?

Eyelid Surgery Highlands, NCIf your upper eyelids have become heavy and saggy or your undereye area has developed bags or dark circles, you may have tried more creams and serums than you care to admit. The fact that the skin around the eyes is thinner than most other areas of the body means that it is the first to show the signs of aging. Although the skin on the face and body does benefit from the use of quality products and ingredients, they cannot correct all the signs of aging, especially where there is excess or stretched skin. In those cases, surgery is the ideal approach.

If you’ve considered the idea of having eyelid surgery, you may be wondering if you are a good candidate for this procedure. This is an excellent question to discuss with Dr. Buchanan. Here, we offer some tips for determining if eyelid surgery is right for you.

How are your upper eyelids?

The upper eyelid skin loses collagen and elastin, the proteins that keep tissue firm and stretchy. The lid area also loses fat, which creates room beneath the skin making it seem looser. In combination, these losses contribute to sagging and upper eyelid hooding. Heavy, saggy upper eyelids can make the eyes look tired and unfriendly. Occasionally, with time, the muscle that holds the lid open also stretches, lowering the lid. In severe cases, excess skin or lowered lid can obscure vision.

Upper blepharoplasty is the eyelid surgery performed to correct these problems. The outpatient procedure is performed in the office using a local anesthetic and, if desired, a mild sedative. To smooth the eyelids, Dr. Buchanan makes an incision in the natural crease of each eyelid. Underlying muscle is tightened and trimmed using small instruments. Excess fat is removed as needed to make the eyelid look more youthful. Finally, the right amount of skin is trimmed to recreate a smooth appearance. If necessary, the muscle elevator of the lid is shortened to elevate the lid to give you a more wide awake look.

How is your forehead?

Why would you pay attention to your forehead when it is your eye area that is exhibiting the signs of aging? Because the forehead can contribute to tired-looking eyes. Sometimes, the forehead muscles and tissue lose resiliency and cause the eyebrows to drop lower than their normal position. This drop in itself can cause the upper eyelids to look bulky by pushing extra tissue into the  lids. When this happens, a brow lift is added  to the blepharoplasty to return the brow to its normal position. On rare occasions, elevating the brow is all that is needed to rejuvenate the eyes.

How is your undereye area?

The skin under the eyes is as delicate as that on the upper eyelids. Its thinning and loss of under eye fat can lead to dark circles or hollowing. This produces bags and puffiness. If the skin is only mildly stretched, a filler below the orbital ligament can return the tissues to a normal appearance. If the skin is too stretched, however, Dr. Buchanan can reverse these age-related changes with lower blepharoplasty. Using the same techniques common for the upper eyelids, lower blepharoplasty smooths the undereye area to look rejuvenated for many years.

Eyelid surgery can bring your face back to life. To learn more, call our Highlands, NC office at (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.

Reasons Fat Transfer May be Ideal for You

Fat Injection Highlands, NCWe recently discussed how facial fat transfer works and what to expect after treatment. With more people considering a move away from off the shelf fillers and toward a more permanent solution to facial volume loss, we understand many questions need to be answered. Here, we discuss some of the top reasons why people choose facial fat transfer over fillers, and why you may want to do the same.

Two Benefits in One Treatment

When we use fillers to restore facial volume, the product we inject is provided by a manufacturer. When we perform fat transfer, the substance that supplies volume is your own body fat. To obtain fat cells for transfer, it is necessary to perform minor liposuction. Patients often choose small areas that are troublesome, such as the hips, flanks, or abdomen, to harvest fat. Liposuction performed under local anesthetic sculpts one area of the body while fat transfer rejuvenates another. All in all, the combination of treatments can refresh both the face and body.

Treatment is Customized

Fat transfer is developed around the needs of each patient. Some patients prefer that more fatty tissue is removed for better body contours. Some need or have very little fat available, so liposuction takes only what is absolutely necessary for contouring the face. As long as sufficient fatty tissue is present, patients may choose to harvest from a variety of areas, but, most commonly, the midsection. It may also be possible to remove fat from under the chin to sculpt the face even more.

As with liposuction, fat injections are also administered based on the areas of concern. Some patients wish to have only one area treated like their lips or cheeks, where others prefer full-face rejuvenation that smoothes and rounds everywhere there is volume loss with properly-layered fat cells.

Results are Natural and Long-Lasting

Though there are several benefits to facial fat transfer, the permanent results that can be achieved with treatment are among the best. It takes approximately 4 months to fully see how much of the transferred fat has survived. After this point, though, new cells are expected to remain indefinitely. As fat cells do, those that are transferred to the face may grow and shrink with weight changes. The overall results will also naturally change as age changes the structure of the skin and underlying bone and fat is further lost naturally. A benefit, however, of fat grafting is transfer of stem cells that can further rejuvenate the area and skin.

Fat transfer is facial rejuvenation with an added bonus of slight body contouring. To learn more about his treatment, call our Highlands, NC office at (828) 526-3783.

Why Consider Facial Fat Transfer To Rejuvenate the Face & Add Volume This Year

Part of the aging process, we have learned, is the loss of volume across the mid-face. Volume loss also occurs at the temples and on the lips. This is one of the reasons why the lower face starts to look wider and saggy as we get older. In recent years, research has discovered that the best way to rejuvenate the face may not be to perform facelift surgery (at least not on its own) but to restore volume using some type of biocompatible substance. Off the shelf fillers do this with temporary ingredients like hyaluronic acid. Facial fat transfer is the technique patients choose when they want permanent results or need significant volume added.

What is facial fat transfer?

Facial fat transfer is the minimally-invasive procedure in which cosmetic concerns are corrected using fat from your own body. Skilled surgeons now also use fat transfer techniques to add or restore volume to areas of the body such as the buttocks and the breasts. More commonly, fat cells are used to give the face a better contour, to fill deflated or thin lips, and to smooth deep creases around the nose and mouth and under the eyes

The treatment is performed in the office using local anesthetic and mild sedation, when needed. There are three parts to the technique:

  • Harvesting fat from a part of the body where you have an excess using liposuction. Common areas include the abdomen and the thighs. If desired, donor area can also be contoured.
  • Purifying fat cells. To add volume to the face, we want pure fat cells. To get them, we wash what is obtained via liposuction. The fat cells are then transferred to a syringe.
  • Transferring fat. The face is treated with local anesthesia before we begin injections. Then, a tiny cannula is inserted under the skin and moved back and forth. With each pass, a line of fat cells is deposited. This technique layers fat cells in a way that achieves natural-looking results.

The visit may last approximately two hours, after which you may return home to recuperate. Most people can return to normal activities by the next day.

What can you expect after increasing facial volume with fat?

After fat transfer, you may experience some swelling and bruising. Discomfort is typically minimal, although both the liposuctioned area and the facial areas treated may feel sore and somewhat tender. This is usually mild enough to manage with over-the-counter medication.

What is important to know about facial fat grafting is that 75 to 80% of the new fat cells introduced to the face are expected to survive. What is present at 4 months is permanent. Because of the loss of some of the fat cells we generally overfill the areas about 10%. Because the transferred fat cells contain stem cells, over time the overlying skin and surrounding tissue may actually improve in quality.

Dr. Buchanan performs facial fat transfer in a way that maximizes success. To learn more about this procedure, call our Highlands, NC office at (828) 526-3783.

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.

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