What is the difference between the following lasers
Posted February 17, 2010 3:47 PM

Question:
What is the difference between the following lasers:
1) erbium 2) fractional erbium 3) co2 laser (ultra plus) 4) fractional co2.... any others?

Answer:
Erbium and CO2 are two different wavelengths of lasers that are both useful for skin resurfacing.  They both cause the skin to peel but CO2 tends to be a stronger, more aggressive laser.  The term "fractional" means that the laser energy is being distributed into tiny fractions of energy spread out across the treatment area instead of treating the area completely.  Treating fractional allows for a faster recovery as treated skin can heal from its neighboring untreated skin.  Therefore it makes sense that the fractional CO2 laser is a great choice for an effective strong treatment but with a "fraction" (one week) of the downtime of a traditional CO2.  I use the Lumenis machine which delivers the energy in a smooth consistent fashion.  I also have an erbium machine in my office for patients with darker skin types or requiring a milder treatment.
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Is it fairly common to have rhinoplasty and chin implants performed at the same time?
Posted February 15, 2010 3:41 PM

Question:
Is it fairly common to have rhinoplasty and chin implants performed at the same time? What are the reasons this is done and what are the benefits?

Answer:
Many patients frequently identify a problem with their nose but they do not realize that they may be lacking in the chin area as well. Having a balanced nose and chin really puts the entire face into balance and allows for a terrific aesthetic result. When the face is in balance, attention is drawn to the eyes and beautiful cheek bones as opposed to staring at an issue with the nose or chin. Chin implants are also very important to the aging process as well. If patients do not have a strong chin, then as they age, they will appear to develop jowls much earlier. The face and neck unit will appear to merge into one. Having a strong chin can help to balance the face and separate the face from the neck. This will help the whole face look better but will also help to maintain a youthful appearance as one ages.
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Can you explain what nasal packing is?
Posted February 14, 2010 3:41 PM

Question:
Can you explain what nasal packing is? How long is it used for and is it always necessary?

Answer:
In years past, the nose was always packed with a gauze-like or tampon-like material to absorb any nasal bleeding after a rhinoplasty. More recently, the type of gauze-like substance has been refined into one that often can dissolve on its own or be much smaller. Even still, the use of nasal packing in general can be uncomfortable and unpleasant when removed the first postoperative day. That is why in the vast majority of rhinoplasties that I perform, all attempts are made to control bleeding during the surgery so packing is not needed. This allows for greater patient comfort and more rapid recovery. Rarely, patients will require the packing and it will almost always be removed the following day. Additionally, patients must abstain from strenuous activity immediately after their rhinoplasty to avoid nasal bleeding and the need for nasal packing insertion in the post-operative period.
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Is FUE a good option for covering a bad scar from a previous hair transplant?
Posted February 13, 2010 3:41 PM

Question:
Is FUE a good option for covering a bad scar from a previous hair transplant?

Answer:
Absolutely. FUE is a virtually scarless technique in which we can dissect primarily single hair grafts and then transplant them into whatever area is needing coverage. This works perfectly for areas of prior scarring because there is no additional scarring and the hairs can be used to cover the hairless area. As a facial plastic surgeon, I have a lot of experience with scar revision and if that is a possibility, during consultation that can be discussed as well.
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I would like get a hair transplant but I am only 26.
Posted February 12, 2010 3:41 PM

Question:
I would like get a hair transplant but I am only 26. Will a hair transplant be able to provide me with a permanent solution given my age?

Answer:
When dealing with younger patients, the most important issue is to evaluate where they are now and where they will be in the future. We commonly recommend the use of Rogaine and Propecia for these younger patients to help them preserve the hair that they have. Our practice also spends a lot of time investigating the history of hair loss within the patient's family to also get a better projection of where the patient will be years in the future. Hair transplants can absolutely provide a more permanent solution but the idea is to plan a very natural hair line taking into consideration the possibility of further loss. In addition, getting a realistic expectation to what future density would look like is also important. Two brand new additions to our practice include laser therapy and the use of platelet-rich plasma. Both of these procedures augment the hair transplant and hair growth. Feel free to contact our practice by phone or e-mail so that we can customize a plan specifically for you.
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I would like to undergo a new revision hair transplant procedure to fix the results of the transplant I had years ago.
Posted February 11, 2010 3:41 PM

Question:
I would like to undergo a new revision hair transplant procedure to fix the results of the transplant I had years ago. I have never been happy with the results. Is it possible to use the old grafts or will all new grafts need to be used?

Answer:
Revising prior transplant procedures performed elsewhere is a common procedure in our practice. It was common in years past to use extremely large grafts which often gave a plug-like appearance. These plugs can be carefully removed and microscopically dissected so that they can be re-implanted but with a much more natural appearance. Also, individual single or double hair grafts can be used to camouflage some of these denser larger grafts which can also help yield a dense but natural appearance. If the concern is the amount of hair density or scarring in the donor area, the follicular unit extraction technique can be used as well.
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Can you explain what the Norwood Scale is for hair loss?
Posted February 10, 2010 3:41 PM

Question:
Can you explain what the Norwood Scale is for hair loss?

Answer:
The Norwood Scale for hair loss is a standardized measuring tool that categorizes the typical fashion in which most men loose their hair. By having this picture scale, doctors across the country can talk about their patients and have it be immediately understood by their colleagues. During your consultation, we would be happy to show you what the Norwood Picture Scale is so you can see your pattern of hair loss and it can also be used as a tool to show you how your hair loss may progress without intervention.
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I am hoping to return to work soon but my rhinoplasty one week ago has left my nose embarrassingly large and swollen.
Posted February 09, 2010 3:41 PM

Question:
I am hoping to return to work soon but my rhinoplasty one week ago has left my nose embarrassingly large and swollen. It looks double in size. What can I do to lessen swelling so that it is not so obvious I've had surgery?

Answer:
The first and most important step at this time is to speak with your physician. There are a number of medications which can decrease some of the swelling faster. In addition, it is important to abstain from strenuous activity. Also, be careful with the use of eye glasses at this time. For approximately one month after rhinoplasty, I advise patients to actually use their cast if they are going to be wearing eye glasses or sun glasses so they are not putting too much pressure in one spot on the nose and perhaps allowing for the accumulation of swelling at the tip. Also, keep in mind that immediately after surgery the nose will look swollen and this will be apparent to both surgeon and patient but the general public often will not notice the difference. Many patients have had surgery and their friends all tell them how great they look but don’t know exactly what is changed. The goal is a natural appearing nose and most friends and colleagues do not exactly remember how your nose appeared beforehand, they will just notice that something is improved and how great you look.
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How soon after my rhinoplasty can I get back to running daily?
Posted February 08, 2010 3:41 PM

Question:
How soon after my rhinoplasty can I get back to running daily? Are there any concerns about being too active too soon?

Answer:
In general, doctors will recommend avoiding strenuous activity or heavy lifting for three weeks after rhinoplasty. The largest risk of being too active too quickly after surgery is that you will have a nose bleed. Nose bleeding or epistaxis can occur if there is an increase of blood flow or pressure to the nasal region. Unlike a typical nose bleed, a post-surgical nose bleed can be quite heavy and severe. Also, if you are really active very quickly after surgery, there can be an increase in swelling to the area and this could delay and possibly affect the ultimate cosmetic outcome. Please consult with your physician after your surgery to determine what the best activity regimen is for you.
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I have been told that fillers shouldn't be used to treat tear troughs.
Posted February 07, 2010 3:41 PM

Question:
I have been told that fillers shouldn't be used to treat tear troughs. Is this true?

Answer:
The tear trough is a delicate area below the eyes that can make one appear tired and sad. Only an experienced injector should attempt to fill in this area. Most fillers are not appropriate for the tear troughs. Safe fillers for the tear trough include your own fat or Restylane. Again, these areas should only be treated by an experienced injector. In my practice this is one of the most commonly treated areas. Be sure to find someone who is skilled in this region. The results can be fantastic when performed correctly. Only a small amount of filler is usually needed to get an excellent result. Treating the tear troughs can thereby be well tolerated, give great results and be cost effective.
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