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    Dallas Lip Augmentation with Restylane – Dallas Plastic Surgery with Dr. Sam Jejurikar

    Tag Archives: Plano plastic surgeon

    Restylane is a hyaluronic acid filler, which is commonly used, in noninvasive cosmetic procedures.  Hyaluronic acid is one of the most common components of human skin.  Filling agents utilizing hyaluronic acid therefore feel natural with virtually no allergic reactions.

    Restylane is the one of the most frequently used fillers and is commonly used as to augment lips.  Medicis, the company that distributes Restylane, recently made some improvements to the product. First, they have introduced a larger (2 mls) syringe, which can allow patients wanting significant lip augmentation to do so at a lesser cost. Second, the company has introduced Restylane with lidocaine, which is a local anesthetic designed to limit patient discomfort during the procedure.

    Other than bruising and minimal discomfort with the procedure, there are minimal side effects with Restylane lip augmentation.  The results typically last from 6-12 months.

    To learn more about noninvasive lip augmentation, including its risks and recovery, don’t hesitate to contact Dr. Jejurikar’s office at the Dallas Plastic Surgery Institute or at Legacy Medical Village in Plano at 214-827-2814.

    In the current health care climate of diminishing reimbursements, more and more physicians are performing cosmetic surgery treatments and procedures.  Unfortunately, many of these physicians are not plastic surgeons and have not undergone the same rigorous training as board-certified plastic surgeons.  All patients should take certain steps prior to scheduling a consultation to ensure that their physician has the highest qualifications to perform cosmetic surgery.
    • Ask if the doctor is a member of the American Society of Plastic Surgeons (ASPS).  Membership in the ASPS ensures that the doctor is certified by the American Board of Plastic Surgery and meets requirements for ongoing continuing medical education.
    • Confirm that the doctor is certified by the American Board of Plastic Surgery.  Merely hearing that a doctor is board certified does not indicate which board has certified that doctor.  There is only one board, the American Board of Plastic Surgery, that is recognized by the American Board of Medical Specialties to certify surgeons in the field of plastic surgery.
    • Find out more about the surgeon’s specific hospital privileges.  Although some procedures are commonly performed in an office or ambulatory surgical center, it is important to learn whether the surgeon has the same privileges in an accredited hospital.  Hospital credentialing committees carefully evaluate a surgeon’s training and competency for specific procedures.  If a surgeon performs a procedure in an office or surgical center, but does not have privileges to perform the same procedure in a hospital, it may be because he was deemed unqualified to perform that procedure.

    Taking these steps before scheduling a consultation with a cosmetic surgeon will ensure that you find a plastic surgeon with the highest qualifications.

    Many of my patients ask how I choose the optimal size for a breast implant. Some women are very concerned about choosing too large of an implant, as they know this can make their breasts look unnatural. Other women worry that they won’t choose a large enough implant to see a discernible difference. To address these concerns, I use a variety of tools and techniques to help my patients select the best breast implant size:

    Photos

    Having patients bring photos of breasts they like and breasts they dislike helps me determine their goals. Visual references are invaluable in understanding each patient’s aesthetic preferences. Some women desire subtle enhancement, while others want a much more dramatic enlargement. By reviewing these photos together, I can better tailor my recommendations to their vision.

    Measurements

    Accurate measurements of the chest wall diameter, breast width, and breast height are crucial. These factors ensure the implant fits the patient’s anatomy. The breast skin envelope has natural limits; selecting an implant that is too large can cause it to sit too high, too low, or too far to the sides, resulting in an unnatural appearance. Taking precise measurements allows us to avoid these pitfalls and achieve balanced, proportionate results.

    Trial Sizing

    In-office trial sizing is a less valuable tool, having being largely replaced by 3D imaging. Although not an exact science, trying on different implants in a bra provides patients with a rough idea of how their new breasts might look in clothing. This exercise often sparks important conversations about their goals and helps patients feel more confident about their choices.

    Conversation

    Every implant has unique characteristics, including shape and profile, which significantly impact the final result. For example, a high-profile implant creates a different appearance compared to a moderate-profile implant, even if they are the same volume. Through open and thorough conversations during the preoperative consultation, I ensure that patients understand these differences and how they align with their desired outcomes.

    3D Imaging with Crisalix

    One of the most exciting advancements in breast augmentation planning is the use of 3D imaging technology like Crisalix. This powerful tool allows patients to visualize their potential results in real time. By uploading images of their body, Crisalix creates a virtual simulation of how different implant sizes and shapes would look on them. This technology takes much of the guesswork out of the decision-making process and provides patients with a clearer idea of their future appearance, helping them feel more confident in their choice. To schedule a 3D breast augmentation consultation using 3D imaging, begin the process by clicking here.

    Intraoperative Sizing

    Even with careful preoperative planning, intraoperative sizing plays a vital role. During surgery, I often use trial implants and sit the patient up to evaluate the breasts from multiple angles. This step is especially important for patients with breast asymmetry, as it allows me to make real-time adjustments to achieve the best possible symmetry and aesthetic result.

    Combining Tools for the Best Outcome

    Each of these tools serves a unique purpose, and together, they provide a comprehensive approach to selecting the optimal breast implant size. My goal is always to create results that are both beautiful and in harmony with the patient’s body. By combining measurements, imaging, trial sizing, and conversation, I can help patients achieve the look they’ve always wanted with confidence.

     

     

    Almost all patients have several questions about the meaning of breast implant profiles.  Patients have seen pictures on the Internet of patients with breast augmentation results they liked and wanted the same style implants as in the pictures.  These patients had a limited understanding as to what breast implant profile refers, prompting this blog entry.

    The naming for implant profiles predominantly refers to smooth, round implants, which are the most common type of implants used for cosmetic breast augmentation.  The profile of the implant has nothing to do with the fill of an implant, with the vast majority of implants placed these days being cohesive silicone gel implants, otherwise known as “gummy bear” implants. The two major breast implant manufactures have different names for their implants.  Allergan refers to its implants as low, low plus, moderate, full and high profile.  Sientra has similar names, but also has a moderate profile plus implant, which is between its moderate and high profile implants. Motiva sticks with the same principles, but gets fancier with its names, referring to the implant profiles in the United States as mini, demi and full. In Europe, they offer an additional profile, Corse, which is the equivalent of an extra high profile implant.

    The profile of an implant equates to the projection of that implant.  For a given volume, the higher the profile, the fatter and narrower an implant is.  As a result, higher profile implants tend to provide more fullness and a rounder appearance to the upper portions of the breast.  Higher profile implants tend to be really useful in women with relatively narrow breasts who want significant enlargement of the breasts; in these women, if a low or moderate profile implant were selected, to achieve the desired volume may entail the implant riding into the underarm region.  In contrast, a patient with a wider build or wider breasts may find that high profile implants may fail to adequately fill their entire breast; they often times benefit from implants with lesser projection.  Higher profile implants also tend to be useful in women who desire a small breast lift without the incisions associated with a formal lift.

    In recent years, there has been a notable shift in the preferences of patients seeking breast augmentation, with increasing interest in low-profile and low-profile-plus breast implants. These implants are characterized by a wider base diameter and less projection compared to high-profile implants. This design creates a more natural, subtle enhancement that aligns with the growing trend toward understated aesthetics. Many patients are prioritizing proportionate results that complement their natural body contours rather than opting for the more pronounced, rounder look traditionally associated with higher-profile implants.

    The appeal of low-profile implants is also influenced by their suitability for specific body types. Women with broader chest walls often find that low-profile implants provide a harmonious fit that enhances their shape without looking artificial or out of proportion. Additionally, these implants are often favored by patients who wish to restore volume after pregnancy or weight loss while maintaining a soft, natural slope to the breast. As societal beauty standards continue to evolve, the demand for implants that achieve balanced, subtle results is expected to grow, making low-profile and low-profile-plus implants a significant choice in modern breast augmentation procedures.

     

    Treatments with injectable fillers, such as Juvederm, Restylane, Radiesse, and Sculptra, not to mention others, can restore a youthful appearance to the lips, nasolabial folds, marionette lines, midface, jowls and lower eyelids, with minimal to no downtime.  Many patients avoid these treatments, though, because they have heard horror stories from friends or colleagues about the pain associated with these treatments.  Suffice it to say, this needn’t be the case – there are steps your plastic surgeon can take to make these treatments more comfortable.

    Recently, BioForm Medical, Inc., makers of Radiesse, received approval from the Food and Drug Administration to mix the filler with lidocaine, an injectable local anesthetic, prior to injection into the skin.  This approval was based on a large study of patients, in which 100% of patients reported feeling less pain when Radiesse was pre-mixed with lidocaine.  Many plastic surgeons, including me, have begun to pre-mix lidocaine with all fillers, including Juvederm, Restylane, and Evolence, not to mention Radiesse, prior to injecting into patients.  The results of treatment are still great, but patients are significantly more comfortable during treatment.

    Others things your plastic surgeon can do to make your treatment with injectable fillers more comfortable include:
    •    Using topical anesthetic gel for at least 30 minutes prior to commencing any injections.
    •    Augmenting treatment with topical anesthetic gel with injections of local anesthetic into nerves above and below the lips.
    •    Using small gauge needles and slow injection techniques

    Combining all of these treatments can ensure that you’ll not only look great after your treatment with injectable fillers, but you’ll feel pretty great during the treatment too!

    The world of dermal fillers has evolved significantly over the past two decades. Once a leading option for non-surgical facial rejuvenation, collagen fillers have largely been replaced by hyaluronic acid (HA) fillers as the go-to choice for patients and providers alike. But why have collagen fillers fallen out of favor, and what makes HA fillers the superior option today? Let’s explore the key differences, benefits, and limitations that have shaped this shift in aesthetic medicine.


    What Are Collagen Fillers?

    Collagen fillers were among the first widely used dermal fillers, offering a way to restore volume and smooth wrinkles. Derived from bovine (cow) or human sources, collagen fillers work by supplementing the skin’s natural collagen levels, which decrease with age.

    Popular collagen-based fillers in the past included Evolence, Zyderm and Cosmoderm. These products provided temporary results, typically lasting around 2-4 months, before requiring re-treatment.


    What Are Hyaluronic Acid Fillers?

    Hyaluronic acid fillers, introduced in the early 2000s, have become the gold standard in non-surgical facial rejuvenation. Hyaluronic acid is a naturally occurring substance in the skin that helps retain moisture, provide hydration, and add volume. HA fillers like Juvederm, Restylane, and Belotero offer immediate, customizable results that can last from 6 months to 2 years, depending on the product and treatment area.


    Why Collagen Fillers Lost Popularity

    Collagen fillers were groundbreaking in their time, but several limitations led to their decline:

    1. Shorter Duration:
      • Collagen fillers typically last only 2-4 months, requiring frequent re-treatments.
      • HA fillers offer significantly longer-lasting results, reducing patient downtime and expense over time.
    2. Allergy Testing Requirement:
      • Bovine-derived collagen fillers required allergy testing weeks before treatment, adding inconvenience for patients.
      • HA fillers are biocompatible, meaning they rarely cause allergic reactions and do not require pre-treatment testing.
    3. Less Versatility:
      • Collagen fillers were primarily used for fine lines and wrinkles.
      • HA fillers are much more versatile, effectively addressing wrinkles, folds, volume loss, and even contouring areas like the cheeks, jawline, and lips.
    4. Advancements in Technology:
      • HA fillers incorporate advanced technology, such as cross-linking, to improve their durability and effectiveness.
      • Collagen fillers lacked these advancements, making them less competitive as newer options emerged.
    5. Safety and Reversibility:
      • HA fillers can be dissolved with an enzyme called hyaluronidase, offering a safety net if patients are unhappy with results or experience complications.
      • Collagen fillers do not have this reversibility feature, making corrections more difficult.

    Why Hyaluronic Acid Fillers Dominate Today

    Hyaluronic acid fillers have set the standard for non-surgical facial rejuvenation thanks to their many advantages:

    1. Natural-Looking Results:
      HA fillers integrate seamlessly into the skin, providing a soft, natural appearance.
    2. Hydration Benefits:
      Unlike collagen fillers, HA fillers attract and retain water, enhancing skin hydration and improving texture.
    3. Customizable Treatments:
      HA fillers come in a variety of consistencies, allowing providers to customize treatments for different areas of the face, from delicate lines around the mouth to deeper folds and volume restoration.
    4. Improved Patient Experience:
      With no allergy testing required, minimal downtime, and long-lasting results, HA fillers offer a more convenient and patient-friendly experience.
    5. Ongoing Innovation:
      Manufacturers continue to improve HA fillers, introducing products with more natural integration, longer-lasting effects, and targeted uses (e.g., Juvederm Volux for jawline contouring).

    Are There Any Benefits to Collagen Fillers?

    While collagen fillers have become less popular, they still have a place in aesthetic medicine. For patients who are specifically looking for subtle, temporary enhancements, collagen fillers may be an option. Additionally, advancements in bioengineered collagen products, such as Sculptra (a poly-L-lactic acid injectable that stimulates collagen production), have renewed some interest in collagen-stimulating treatments rather than collagen as a filler material.


    The Bottom Line

    The rise of hyaluronic acid fillers over collagen fillers is a testament to the progress and innovation in aesthetic medicine. While collagen fillers paved the way for modern injectables, HA fillers offer superior longevity, versatility, safety, and results, making them the clear choice for patients and providers today.

    If you’re considering injectable treatments to rejuvenate your appearance, schedule a consultation with a board-certified plastic surgeon or experienced injector. They can guide you through your options and recommend the best product to help you achieve your aesthetic goals.

    Are Trendy, Branded Cosmetic Procedures Right for You? Insights for 2024

    The cosmetic surgery industry has evolved dramatically over the past 15 years. However, one challenge remains constant: the growing trend of marketing branded surgical and nonsurgical procedures as quick fixes for aesthetic concerns. Names like “Lifestyle Lift,” “Thread-Tox,” and “Smart-Lipo” promise miraculous results with little to no downtime. But are these highly marketed procedures the best option for achieving your desired results? Experts emphasize that while marketing has advanced, patient safety and outcomes must always remain the top priority.


    Understanding Branded Procedures

    Branded procedures often fall into two categories:

    1. Named for the Innovator: These are techniques associated with a specific surgeon or researcher who popularized the method, such as Saldanha’s lipoabdominoplasty or Furnas’ conchal setback technique. These techniques are typically validated through rigorous scientific research and documented in medical literature.
    2. Marketing-Driven Branding: These procedures are often created as marketing tools, designed to appeal directly to consumers with catchy names and bold promises. While they may offer some benefits, their efficacy and safety often depend heavily on the practitioner’s training and skill.

    The Importance of Expertise Over Branding

    As new technologies and procedures emerge, the Aesthetic Society continues to stress that a procedure is only as effective as the surgeon performing it. Branded procedures often simplify or oversell the complexities of aesthetic surgery. This can lead to mismatched expectations and, in some cases, unsafe outcomes.

    Dr. J. Peter Rubin, a board-certified plastic surgeon, highlights the importance of selecting the right procedure for the right patient. “In the wrong clinical setting, the results may not come close to the promises made in the advertising,” he says. The judgment and expertise of a board-certified plastic surgeon remain the most critical factors in achieving optimal results.


    Matching the Patient to the Procedure

    Marketing for branded techniques often implies a one-size-fits-all solution. However, according to Dr. Sherrell Aston, past-president of the Aesthetic Society, “The human anatomy and aging process vary significantly from person to person. A single facelift technique, for example, cannot appropriately address the unique needs of every individual.”

    Short-incision facelifts, “minimally invasive” techniques, and other marketed solutions can yield excellent results—but only when tailored to the right patient by a highly skilled surgeon.


    Patient Safety in 2024

    Patient safety has become an even more critical focus in today’s cosmetic landscape as the demand for procedures has surged, along with the number of underqualified providers offering them. Procedures such as facelifts, liposuction, abdominoplasty, and breast surgeries require extensive training and expertise.

    Dr. Renato Saltz, a past president of the Aesthetic Society, emphasizes that the rigorous residency training required for certification by the American Board of Plastic Surgery (ABPS) equips surgeons to handle the complexities of these procedures. This training ensures not only technical skill but also an understanding of ethics, safety, and patient-centered care.


    How to Choose the Right Surgeon and Procedure

    If you are considering a cosmetic procedure, follow these steps to ensure your safety and satisfaction:

    1. Research the Procedure Thoroughly: Understand the potential benefits, risks, and recovery time for the procedure you’re considering. Avoid being swayed solely by catchy names or marketing claims.
    2. Verify Your Surgeon’s Credentials: Ensure your surgeon is certified by the American Board of Plastic Surgery (ABPS) or an equivalent, recognized certifying board. This certification demonstrates extensive training and expertise in aesthetic surgery.
    3. Ask About Experience: Choose a surgeon who specializes in the procedure you’re considering. Ask how many similar procedures they’ve performed and request to see before-and-after photos.
    4. Prioritize a Tailored Approach: A skilled surgeon will evaluate your unique anatomy and goals to recommend the best procedure for you, whether or not it’s a branded technique.
    5. Understand Informed Consent: Ensure that your surgeon fully explains the procedure, risks, benefits, and alternatives. Take the time to read and understand all consent documents before signing.

    The Evolution of Minimally Invasive Procedures

    In 2024, advances in technology have introduced new, minimally invasive options for facial and body rejuvenation. Treatments such as radiofrequency microneedling, laser liposuction, and injectable fillers can address some aesthetic concerns with less downtime than traditional surgery. However, these are not replacements for surgical procedures in cases requiring more significant changes. Consulting with a qualified plastic surgeon ensures that your chosen treatment aligns with your goals and delivers realistic, long-lasting results.


    Conclusion: Expertise Matters More Than Branding

    Branded procedures may promise convenience and fast results, but the most critical factor in cosmetic surgery remains the skill, training, and judgment of your surgeon. Marketing trends come and go, but patient safety and individualized care are timeless. By choosing a board-certified plastic surgeon and prioritizing a personalized approach, you can achieve beautiful, natural results that align with your aesthetic goals.

    If you’re considering a cosmetic procedure, visit the Aesthetic Society at www.surgery.org to learn more about qualified providers and the latest advancements in the field. Your safety and satisfaction depend on making informed decisions guided by experts.

    Neurotoxins, including Botox, Dysport, and others, are some of the most popular and effective treatments for reducing wrinkles, fine lines, and other signs of aging. These injectables work by temporarily relaxing targeted muscles, giving the skin a smoother, more youthful appearance. Let’s explore the key neurotoxins used in the U.S., their FDA-approved indications, off-label uses, and the pros and cons of each.


    How Neurotoxins Work

    Neurotoxins are derived from botulinum toxin, a purified protein that blocks nerve signals to muscles. By inhibiting muscle contractions, neurotoxins effectively reduce dynamic wrinkles—lines that form due to repetitive facial movements.


    FDA-Approved Neurotoxins in the U.S.

    1. Botox Cosmetic (OnabotulinumtoxinA)

    • FDA-Approved Indications:
      • Glabellar lines (frown lines between the brows)
      • Crow’s feet (lines around the eyes)
      • Forehead lines
      • Axillary hyperhidrosis (excessive underarm sweating)
      • Chronic migraines
      • Overactive bladder
      • Cervical dystonia (neck muscle spasms)
    • Off-Label Uses:
      • Lip flip (upper lip enhancement)
      • Gummy smile correction
      • Jaw slimming (masseter muscle relaxation)
      • Bunny lines (nose wrinkles)
      • Neck bands (platysmal bands)
      • Perioral lines (smoker’s lines)
    • Pros:
      • Most studied and widely used neurotoxin.
      • Predictable, reliable results.
      • Versatile with a broad range of applications.
    • Cons:
      • Slightly higher cost compared to competitors.
      • Results can take 5-7 days to become noticeable.

    2. Dysport (AbobotulinumtoxinA)

    • FDA-Approved Indications:
      • Glabellar lines (frown lines)
      • Cervical dystonia
    • Off-Label Uses:
      • Similar to Botox, including crow’s feet, forehead lines, and masseter reduction.
    • Pros:
      • Diffuses more readily, making it ideal for treating larger areas.
      • Results may appear faster (within 2-3 days for some patients).
    • Cons:
      • Diffusion can be a disadvantage in small, precise areas, potentially causing unintended muscle relaxation.
      • Requires slightly more units than Botox for equivalent results.

    3. Xeomin (IncobotulinumtoxinA)

    • FDA-Approved Indications:
      • Glabellar lines
      • Cervical dystonia
      • Blepharospasm (eyelid spasms)
    • Off-Label Uses:
      • Crow’s feet, forehead lines, and masseter reduction.
    • Pros:
      • Contains no additives, reducing the risk of developing resistance or immunity over time.
      • Results are comparable to Botox.
    • Cons:
      • Effects may take slightly longer to set in (5-7 days).
      • Some providers find it less versatile than Botox or Dysport.

    4. Jeuveau (PrabotulinumtoxinA-xvfs)

    • FDA-Approved Indications:
      • Glabellar lines
    • Off-Label Uses:
      • Crow’s feet, forehead lines, and other facial wrinkles.
    • Pros:
      • Marketed as a “modern” alternative to Botox with similar efficacy.
      • Competitive pricing compared to Botox.
    • Cons:
      • Limited FDA-approved uses compared to other neurotoxins.
      • Less long-term data compared to Botox and Dysport.

    5. Daxxify (DaxxibotulinumtoxinA-lanm)

    • FDA-Approved Indications:
      • Glabellar lines
    • Off-Label Uses:
      • Similar to Botox but not as widely adopted yet.
    • Pros:
      • Longer duration of results—lasting up to 6 months, which is twice as long as other neurotoxins for many patients.
      • Ideal for patients seeking fewer treatments per year.
    • Cons:
      • Limited availability and higher cost.
      • Newer product with less widespread use and clinical data.

    Comparing Neurotoxins: Choosing the Right Option

    Neurotoxin Onset Duration Best For Price Point
    Botox 5-7 days 3-4 months Precision and versatility $$
    Dysport 2-3 days 3-4 months Larger areas with faster onset $$
    Xeomin 5-7 days 3-4 months Patients prone to resistance $$
    Jeuveau 5-7 days 3-4 months Cost-conscious patients $
    Daxxify 5-7 days 4-6 months Long-lasting results $$$

    Weighing the Pros and Cons of Neurotoxins

    Pros:

    • Quick, Non-Surgical: Minimal downtime and immediate return to daily activities.
    • Customizable Results: Treatments are tailored to each patient’s needs.
    • Preventative Benefits: Early use can prevent deeper wrinkles over time.

    Cons:

    • Temporary Results: Maintenance treatments are required every 3-6 months.
    • Potential Side Effects: Includes bruising, swelling, or asymmetry if improperly administered.
    • Cost: Ongoing treatments can add up over time.

    Conclusion: The Right Neurotoxin for You

    Each neurotoxin offers unique benefits, and the best choice depends on your specific goals, treatment area, and preferences. It’s essential to consult with an experienced provider to determine the ideal option for your needs.

    If you’re ready to explore neurotoxin treatments, schedule a consultation with our office today to learn more about how Botox, Dysport, and other options can help you achieve your aesthetic goals!

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    Our Location Dallas Plastic Surgery Institute

    9101 N. Central Expwy.
    Suite 600, Dallas, TX 75231
    Tel: 214.827.2814
    Dallas | Dr. Jejurikar

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