Beauty is a very difficult thing to define. There are certain faces that are very asymmetric and whose parts are individually not attractive, yet somehow it “works”. In general though, faces that are more symmetric, covered by smooth, even skin and following certain “norms” are considered more attractive. Especially on the side view, the chin forms a major aesthetic highlight of the face.
If you look from the side and drop a vertical line from the vermilion (where the red of the lip meets the white of the lip), it should approximate ideal chin position in a man. Ideal chin projection would be a few millimeters behind this line in a woman. Obviously, these are rough guides that need to be adjusted based on the rest of the person’s facial features.
There are several options for the weak chin. If there is a significant bite problem (overbite, under bite) and the patient is willing to undergo up to a year of orthodontic treatment and traditional jaw surgery, then this is an excellent option. If the patient does not want or need traditional jaw surgery but does not want an implant, then a genioplasty is an excellent choice. Here, a small incision is made in the mouth and a small cut made in the chin itself moving it forward. It is held in place with small plates and screws. The best option for an implant (again usually placed through the mouth) is silastic. It is well tolerated and very few patients develop any issues with it. The good thing about it is that if there is an infection, or if the patient doesn’t like it for any reason, it is fairly easy to remove. This is rarely needed.
The weak chin can accentuate upper neck fullness making a double chin more prominent. They should be thought of as a unit. If someone has too much fatty tissue below a weak chin, then doing a small amount of liposuction at the time of chin augmentation is very beneficial. If there is a lot of lax tissue below the chin, this won’t really improve unless it is suspended with a neck lift type procedure.
Dr. Ducic has written several peer reviewed publications in medical journals on both genioplasty and chin augmentation. You may view these at dfwplasticsurgery.com.
We look forward to meeting with you to determine what the best option is for making your weak chin no more. Call our Colleyville office at 817-503-2442 or our Fort Worth office at 817-920-0484 to schedule a complementary consultation.
The nose has a vital functional significance. It serves to humidify and filter the air that we breathe. In addition, all of our sinuses drain into the nasal cavity. So it is important to maintain and restore proper function of the nose to allow for optimal comfortable breathing.
It is true that generally, a nose that looks well breathes well. Certainly, function and appearance go hand in hand. The nose should not stand out but, rather should blend with and be in balance with your other facial features. If there is deviation of the root of the nose, it needs to be refractured and reset in the proper position. If there is a hump, it needs to be taken down in order to allow the nose to be reset properly. The nose needs to have good support in order to be stable over time but also for a more natural and functional appearance. Most of the time, we can obtain any cartilage we need from the septum. If this is not enough, then we can obtain it from either the back of the ear or the rib.
Rhinoplasty may be done either closed or open. Closed means that all the incisions are inside the nose. With an open or external approach there is a small incision across the columella between the nostrils. Closed approach is good when there is not much need for grafting or a lot of work that needs to be done on the tip of the nose. There is less swelling and a much shorter recovery. The open approach allows the surgeon to visualize all the cartilages directly and allows for more precise extensive reconstruction. The drawback of the open approach is prolonged swelling that may last up to a year. It is howevere, the best way to approach someone with severe deformities or needing a lot of tip work.
It should be remembered that there is, as with any surgery, a need for revision in a small percentage of patients. In rhinoplasty, between 5-10 percent of patients need a revision or touchup procedure. We usually defer any such surgery for one year until the swelling has resolved.
This is generally not a painful procedure, with most patients taking only Tylenol for their discomfort. There is often a small cast on the nose for 2-3 weeks. It needs to stay dray but light activity even a day after surgery is otherwise fine.
Each nose is unique as is each face it has to be matched to. Thus, it is important for us to evaluate and share with you exactly what can and should be done to improve the appearance of your nose and its function. We look forward to meeting with you in the office for an evaluation.
IPL, also known as Photofacial or intense pulsed light, was first introduced in the 1990s. It is one of our go to treatments for patients with sun damage, discolored skin, acne, large pores, freckles, broken capillaries and superficial scarring.
How does IPL work?
Broad spectrum light is transmitted through a continuously cooled applicator, gently placed over the skin. Filters in the handpiece create a custom application for different skin types. The light penetrates the tissue and is absorbed by the relevant chromophores and damages them (blood chromophores when treating vascular lesions, and melanin chromophores when treating pigmented lesions). The body’s natural processes then clear the lesion debris, giving the skin a more even and youthful appearance.
Will I see a bright light?
Eye protection is important. We will apply eye shields to your eyelids that are specially made for IPL treatments. You might still see a flash of light, but your eyes will be protected.
How many treatments do I need?
Multiple treatments may be necessary in order to achieve the desired result. I typically recommend three to six treatments at one-month intervals.
What should I expect from my treatment?
The treatment itself takes anywhere from 15 to 45 minutes. Gel is applied to the skin, the area is treated and then a sunscreen is applied. If you’re suffering from sun damage your spots will appear as if they are coffee grounds. Don’t worry, they will shed off. Some redness is expected and can last throughout the day. Some patients experience mild swelling.
Should I have this done before a facelift?
Dr. Ducic will often recommend starting a series before a procedure. Think of your skin as a tablecloth. You wouldn’t want to put a dirty wrinkled tablecloth on a beautiful table.
Can I do it on my lunch break?
Of course. It’s fast, and make-up can be applied immediately following the procedure.
Can I have an IPL treatment on my hands?
Don’t you just hate those dark spots that you see when driving in your car. Yes you may! It’s a very popular area to have treated.
How should I maintain my improved complexion?
Here at the Center for Aesthetic Surgery, we work together as a team. I will help you maintain your skin with various procedures, but it is just as important to have a good home care regimen. When you come in for your consultation bring your skincare with you. We will go over it together and I may recommend changing a few things.
Call today for a free consultation. Here at the Center for Aesthetic Surgery we offer a wide range of services including Micro-Needing “SkinPen”, Microdermabrasion, Chemical Peels, Facials, Waxing, LED Light Therapy, Spray Tan, IPL, Isolaz, ResurFX, Photofractional, Lamprobe, Laser Hair Removal, ThermiSmooth and so much more.
There has been a traditional stigma associated with facelifts. Patients rightly have a natural aversion to a tight, pulled or unusual looking facelift result. “We have all seen some very unnatural looking results in even some of the most famous celebrities, said Yadro Ducic, M.D., FACS.
Natural Results
“The goal of facelift surgery should be to reverse some of the signs of aging,” he continued. “When there is sagging of jowls, flattening of cheeks and neck laxity, that all can be helped by this surgery. Our goal is to improve but not erase these signs of aging. When we try to erase them is when we are left with a very ‘done’ look.” The goal of plastic surgery should be to look fresher, more youthful, better rested. Some laxity is not only fine, it is desirable.
Dr. Ducic explained the various types of facelifting techniques available.
“The basic distinction has to do with the extent of dissection and the depth of dissection. In general terms, the more extensive and deeper the dissection, the more natural, longer-lasting the results. These more extensive dissection techniques are also associated with more down time,” So called “mini-lifts” involve simple skin repositioning in a limited fashion. This is useful in patients that have only small amounts of sagging and are thin. Downtime is minimal; results are generally not as long lasting. Deep plane facelifts are generally recommended for patients with more significant signs of aging. “Here, recovery may take two to three weeks,” he said. The results tent to be much more natural and long-lasting.
Adjunctive techniques should always be considered in facelift patients. Fat grafting in the central face, liposuction of the neck and lip lift/augmentation procedures are often complementary to standard facelift techniques and can have dramatic effects when combined.
Dr. Ducic has authored articles on facelifting and mid face lifting techniques and would welcome the opportunity to help you evaluate which technique is best suited for you.
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Dr. Yadro Ducic is the medical director of the Center for Aesthetic Surgery in Colleyville, Texas. He is certified in both Facial Plastic Surgery and in Otolaryngology-Head and Neck Surgery. Book a consultation today.
Our society has had an ongoing obsession with limiting fat in our diets and on our bodies for a number of years. Certainly being overweight may not be healthy or desirable, but fat itself has gotten a bad reputation. Fat cells are important sources of energy in our body, storing git during times of plenty. Unfortunately, we can’t control where it is stored.
Aging Skin
Once we reach puberty, the number of fat cells we have remains unchanged throughout or lives. When we gain weight, our fat cells swell. Conversely, they shrink whenever we lose weight. In the face, we not only develop laxity or loosening of tissues as we age, but also lose volume, especially in our central face and cheeks. This gives older people a drawn, haggard sunken appearance that looks tired. Sometimes, the right thing to do is resuspend the droopy loose tissue as in a mid-facelift or facelift. However, often what is needed is adding back some volume where it has been lost.
Our Own Skin May be the Answer
Fat can be harvested from areas we don’t need it, in the abdomen, flanks or highs, processed immediately, and then injected into the face where we need it. In our experience, 80% of patients retain some or all of their transplanted fat long-term. These cells live in their new home on the face.
Fat cells that are transplanted as described above also appear to impart beneficial effects on the overlying skin aside from just filling it out. There may be some stem cell like elements that have a capacity to improve skin appearance which we don’t fully understand.
Although there are a lot of options for facial augmentation, both temporary and permanent, fat should always be considered as it is easy to harvest, inject, works well in most people and has minimal potential side effects as it is harvested from the patients own body.
Learn More
Some of our doctors at Center For Aesthetic Surgery have published articles and lectured extensively on the use of fat grafting and would welcome the chance to meet with you and personally discuss whether this would be a good option for you.
Question 1: How Does Liposuction Differ from a “Tummy Tuck” (Abdominoplasty)?
In liposuction, small openings in the abdomen are used for access to suction and remove fat from the abdomen and this may extend to the flank area. This is best for removal of isolated areas of fat deposition, and this will often result in a contouring of the abdomen and waist. In our youthful years, the abdominal skin is better at regaining the shape and integrity. The elasticity of the skin often has better contraction and will regain the original shape and appearance. As we mature, the skin may not regain shape and integrity like it did in our youth. This is an aspect to consider about liposuction, as it may result in excess skin after the liposuction or some redundancy in the skin.
A “tummy tuck” (abdominoplasty) is often used to tighten the abdominal wall muscles and remove the excess skin of the abdomen. Most often this is done with an incision along the lower bikini area and it may include an incision around the umbilicus. The “tummy tuck” often is combined with some liposuction to achieve a more balanced appearance. Most commonly this is in someone with previous pregnancy and excess skin in the lower abdomen after delivery and in patients after losing a significant amount of weight and the skin does not contract with the weight loss. Each has a place in reshaping and recontouring; and a discussion with your surgeon may help to determine what is best for you.
Question 2: What is the Difference Between Silicone and Saline Breast Implants? How Do I Know Which is Best for Me?
Breast implants have two different substances used for filling, one is silicone – a substance used for many items around and in the human body. It is used because of its low reactivity with the human body and is tolerated well. It is used in syringes for diabetics and orthopedic implants for joints among other things. It has been used for years with a long track record of safety. The breast implants have been studied extensively and are currently approved by the FDA for cosmetic and reconstructive purposes.
Saline implants are breast implants with a silicone shell like the silicone implants, but the filler is saline, a dilute saltwater mixture. One difference is the way the implant feels due to the implant filling. The saline has a more water-like feel and the silicone has a thicker consistency due to the silicone and a little more tissue-like in feel. If there is a break in the shell of the implant, the saline will be absorbed by the body whereas the silicone will remain in place. Most of the implants used today have a thick viscosity and the silicone is a gel which will remain in the capsule around the implant. In both cases, the implant can be removed and replaced.
Which implant is best for nay one patient is dependent on many factors. Both types of implants come in a variety of shapes and sizes. This decision is best determined after a full exam and discussion with your surgeon on your goals, with the development of a customized plan.
Question 3: When Do I Need Breast Implants and When Do I Need a Lift, and Sometimes Do I Need Both?
This is a very interesting and complex question with the answer varying from person to person depending on the body shape, breast shape, and skin type. Generally speaking, breast implants are used to enhance the appearance of the breast with enlargement and increase in volume. Ideally, this is a breast with mild to no excess skin and no sagging of the breast. In this situation the implant can result in good breast appearance and position of the nipple areola. All of our current knowledge indicates no contraindications for breastfeeding after breast implants is desired.
Often in the postpartum breast, there is an excess of skin after loss of volume at the completion of lactation. This may be accompanied by some sagging of this excess skin and change in the position of the nipple areola. If the volume of breast tissue present is satisfactory, a “lift” (mastopexy) may be all that is necessary to remove the excess skin and reshape the breast. This involves scars around the areola and a vertical component extending to the lower breast crease. Often a transverse aspect of this scar along the breast crease is necessary to achieve the shape desired.
The next area to address is the patient who desires an increase in volume and has an excess of skin present. This will require an implant and a “lift.” This is a procedure which can be done as two separate procedures or as one procedure; however even when done as one, a second procedure may be necessary to achieve a good result. Each situation requires a full exam and discussion of your goals and discussion with the surgeon about weather these can realistically be achieved and what the risks are.
Question 4: I Have Very Large Breasts and Have Been Told to Have a Breast Reduction. When Should I Consider This Option?
The most common reasons for a having a breast reduction are back pain, neck pain, and breakdown of the skin under the breast – which may include chronic yeast infections. This is one of the most common procedures performed by plastic surgeons, and can be a radical change in the day-to-day life of a person. Many times, every day when coming home, the patient will have pain in the back and neck, which impairs the patient from many of the usual activities of daily living due to pain. It can affect the ability to exercise and perform some jobs. In a reduction, tissue is removed and the breast is reshaped after removal. The breast has scars around the areola the a vertical scar down to the breast crease and a transverse scar in the breast in most cases. In most cases, over a pound of tissue is removed from each breast. This may or may not be covered by insurance. It may impair the ability to breastfeed and sensation in the nipple areola may be lost. Most patients feel this risk is well worth it to resume many activities they were unable to enjoy and are very satisfied.
Question 5: What Credentials Should I Look for When Finding a Qualified Plastic Surgeon?
A qualified plastic surgeon will have had training in an approved plastic surgery graduate medical program – which leads to certification by the American Board of Plastic Surgery. This is a rigorous training of at least six years after medical school. Other qualifications to look for include membership in the American Society of Plastic Surgery and/or American Society of Aesthetic Plastic Surgery. These all indicate a level of training to deal with the complexities of plastic surgery. In addition, a consultation with the surgeon and discussion about their approach to surgery in your case may demonstrate an approach with which you are comfortable. Ask to see pictures of previous patients with a similar surgery as you plan to have. It is important for you to be able to discuss with your surgeon your desires if you are to achieve a good outcome. A relationship of trust and communication will be in your best interest.
Contact Center For Aesthetic Surgery in Colleyville, TX today, for a consultation you are sure to feel comfortable in.
Be Comfortable in Your Own Skin
When shape, appearance and/or size of the breast is not what is desired or is uncomfortable, a contributing factor to this problem may many times be significant asymmetry.
Many items may play a part in the breast and it’s appearance including development or lack of development, aging, pregnancy, weight changes, injury or previous surgery. This appearance may be altered with a breast lift, which can occur with the re-adjustment of the nipple areola position or may require a breast reduction with the removal of a significant amount of tissue. The full spectrum of these procedures can be used to achieve a shape and size more pleasing and in keeping with the desire for one’s life style.
Achieve Symmetry
Many women have development of breasts, which have a significant asymmetry causing problems in clothing and may be uncomfortable due to the weight difference. These developmental asymmetries can often be addressed with a breast lift or a breast reduction on one side and/or a small implant on the other side to achieve symmetry. If a patient is developing very large breasts that are disproportionate to the rest of the body, a breast reduction may accomplish a more harmonious shape and relieve the pain of the large breasts. The pain may be backache, neck ache or constant breakdown of the skin under the breasts. After breast reduction not only can there be relief of pain, but more active physical activity can be undertaken. The amount of weight removed can vary from person to person. In some cases, if the weight of the breast tissue removed is significant, the procedure may be covered by insurance.
Shape
Many times with age or after pregnancy, changes occur in the breast leaving an appearance not very desirable. There may be loss of volume and/or sagging, which is called ptosis, in the breast. The location of the nipple areola may change in relation to the body of the breast. Reshaping of the breast with repositioning of the nipple areola and possible skin removal will help.
In these cases, an incision is necessary and in most cases, these are placed in areas, which are concealed or the incisions will often fade over time and not be perceptible. In some cases, to achieve better shape with the lift a breast implant, may be considered. Many variations in lifts can be used to achieve a better appearance depending on the individual variation.
Weight change can affect the breast especially in the massive weight loss patient but any degree of weight loss can cause significant ptosis of the breast. A breast lift is often necessary to reshape the breast and reposition the nipple areola. The excess skin can often extend to the area under the arm or onto the back requiring this to be addressed. If the volume loss is too great a breast implant may be necessary to achieve a balanced shape.
Lastly, in those with previous surgery on the breast or injury to the breast the shape may have been what was desired at the time of surgery. With the passage of time changes may occur for many reasons and the shape is not what is desired. If implants are present they may need to be removed or adjusted and a breast lift may restore shape which is more appealing.
What to Expect
Breast lift and/or breast reduction can often be accomplished in an outpatient setting and not require an overnight stay. The incisions are around the nipple areola which may be adjusted in size and extended to the crease under the breast with extension along this crease necessary in some cases. The degree of incisions required is often dependent on the amount of tissue being reshaped. These incisions heal and in most cases will settle into the surrounding tissue shape and appearance.
Breast lift and/or breast reduction offers patients an opportunity to achieve a shape, appearance, and size of the breast for their life style. A consultation at Center For Aesthetic Surgery in Colleyville, TX can help explore your goals and how best to achieve these goals with discussion of associated risks. Time is taken to address your personal questions and the consultation is centered around your individual needs and your desires for your breast shape, size, and what your goals are to improve your appearance.
Call Center For Aesthetic Surgery today at 817-503-2442 for an appointment regarding any of these breast lift or breast reduction procedures or other cosmetic or reconstructive plastic surgical procedures or other cosmetic or reconstructive plastic surgical procedure.
Function vs. Beauty
The nose represents a prominent aesthetic highlight in the middle of the face. Ideally, it should blend with the surrounding facial structures in perfect balance. It should not stand out, either because of size, shape, or asymmetry. When people look at you, they should notice and maintain their focus on your eyes and mouth as you are speaking. The nose should not detract from either.
Aside from its aesthetic role, the nose has a very important function. It serves to warm and humidify the air that we breathe. To appreciate this function, think of times when you have been unable to breathe normally, such as during a bad cold. Deviation of the septum is a common problem that can be addressed surgically and does not generally change the outward appearance of the nose. Some patients, however, have deviation of the outside of the nose because of congenital problems or a history of trauma. If this deviation is not repaired at the time of surgery for aesthetics, the breathing that one is able to achieve after surgery will be suboptimal.
Thus the old adage, ” a nose that looks good often breathes well,” certainly applies.
It is Important for Your Nose to “Work” Properly
We can reshape the nose, correcting airway issues and visible asymmetries on the outside at the same time. This provides the patient a nicely shaped, symmetric nose that has excellent function. There may be desire on the patient’s part to have a “smaller nose.” While this is often achievable, there is a limit as to how small it should be for both form and function. If the size of the nose is reduced too much, you begin to lose function permanently, which can only be repaired with secondary reconstructive surgery. Also, a nose that is too small for one’s facial features brings them out of balance just as much as one that is too large. In addition, it will have the look of a “done” nose. Also of critical importance is adequate support; long term, without such support, the nose will begin to twist and collapse, contributing to the “dome” appearance.
Professional Results
Our goal at Center For Aesthetic Surgery is to achieve a result that is symmetric, long lasting, fits the face, and allows you to breathe well. Various techniques may need to be employed. Sometimes, we are able to reach our goals with incisions hidden inside the nose with minimal swelling. At other times, a small incision may be needed across the base of the nose, which is imperceptible. This allows us to work directly on the framework, placing small, precise pieces of carved cartilage into areas of the nose that are indented or lacking in support. We can use cartilage from the crooked portion of the septum (much like recycling), or occasionally from the back of the ear (without changing its shape or affecting hearing), or from the rib (through a small incision hidden below the breast). We prefer to use your own cartilage, rather than cadaver cartilage or synthetic materials because of the lower risks of infection and rejection.
If you are contemplating Rhinoplasty contact us at Center For Aesthetic Surgery in Colleyville, TX today!