Cosmetic Dermatology

Read articles about cosmetic dermatology, fillers, Botox, light therapies and other new modalities.

How Do I Choose a Surgeon?

Plastic surgery is a serious undertaking, and requires a lot of trust in the performing surgeon. In this video we asked plastic surgeon Dr. Bryce Cowan what patients should be looking for when choosing a plastic surgeon or a clinic.

Advances in Techniques for Endovenous Ablation of Truncal Veins

The latest techniques for endovenous occlusion, i.e., radiofrequency ablation catheters or endoluminal laser targeting water are our preferred methods for the treatment of saphenous-related varicose veins. Clinical experience with endovenous techniques in more than 1,000 patients shows a high degree of success.

Ideal Fat Graft Candidate

In this video plastic surgeon Dr. Bryce Cowan explains the ideal candidate for a fat grafting procedure. Every procedure has its strengths and weaknesses, and it’s important that patients understand these factors as well as the cost and risks that they are willing to tolerate. An important video for those considering fat grafting.

Fractional Laser Treatment for Pigmentation and Texture Improvement

Fractional laser treatment with the 1,550nm erbium fiber laser (Fraxel® Laser, Reliant Technologies) has bridged the gap between the ablative and nonablative laser modalities used to treat the epidermal and dermal signs of skin aging.

Blepharoplasty: Laser or Cold Steel?

Blepharoplasty of the upper and/or lower eyelids can restore a youthful appearance to the aging face. This is a minimally invasive procedure that can be accomplished with little bleeding and a small incision.

Nonablative Laser and Light Therapy: An Approach to Patient and Device Selection

Nonablative laser and light therapy is a relatively novel modality for the improvement of the visual appearance of photodamaged, scarred, and injured skin. A number of different wavelengths and devices have been purported to be efficacious for the delivery of nonablative therapy.

Limited Breast Reduction by Liposuction

We describe a method for liposuction reduction of female breasts that is safe, efficacious, and associated with high levels of patient satisfaction. Liposuction for breast reduction in women is an appropriate addition to the array of liposuction procedures available to the dermatologic surgeon.

Update on the Botulinum Neurotoxins

The botulinum neurotoxins (BTX) are an exciting group of therapeutic agents with dramatically expanding clinical indications. The US FDA has approved BOTOX® (BTX-A, Allergan) and Myobloc™ (BTX-B, Elan Pharmaceuticals) for the treatment of cervical dystonia.

Risks Associated with Fat Grafting

Plastic surgeon Dr. Bryce Cowan explains the risks associated with the fat grafting procedure that patients should be aware of before undergoing the procedure. Although serious complications are rare, it’s important to be aware of the various potential risks.

An Algorithm for the Reconstruction of Complex Facial Defects

Dermatologic surgeons are often faced with the repair of complex facial defects following Mohs micrographic surgery. While the size or absence of critical tissue layers may be daunting, the reconstruction of these complex defects follow similar principles to those for the closure of smaller, simpler defects.

Recovery Time After Fat Grafting Procedure

Plastic surgeon Dr. Bryce Cowan explains what expectations patients should have in terms of recovery time. Can patients go right back to work the next day, or run a marathon?

Platelet-Rich Plasma (PRP): Current Applications in Dermatology

Platelet-rich plasma (PRP) is an autologous serum containing high concentrations of platelets and growth factors. PRP continues to evolve as an important treatment modality with many applications in dermatology, particularly in the areas of hair restoration, skin rejuvenation, acne scars, dermal augmentation, and striae distensae.

How does Aging of the Face Manifest Itself?

The upper, mid, and lower face all age as we go through the decades. Dr. Bryce Cowan explains how symptoms of aging typically manifest over time.

Twelve Technical Strategies to the Perfect Surgical Scar

Achieving an excellent surgical result while managing disease can be a daunting task when the basic surgical principles we were all taught have been lost to time and the perpetuation of poor surgical habits that were adopted from others. Here are strategies that can help to improve your scar outcomes.

Artecoll® – an injectable micro-implant for longlasting soft tissue augmentation

Never before have so many people sought our assistance to help get get rid of their wrinkles. Until recently, most biological materials presented shortcomings – resorption within months, allergic reaction, and on occasion, foreign body or granuloma formation at the site of injection.

Poly-L-Lactic Acid as a Facial Filler

Poly-L-lactic acid is a filler recently approved by the US FDA for the correction of facial lipoatrophy in patients infected with the human immunodeficiency virus (HIV). Currently, poly-L-lactic acid, sold under the brand name Sculptra™ (Dermik), is the only product approved by the FDA specifically for this indication.

Chemical Peels

With so many new peel preparations on the market today, the dermatologist must ask himself basic questions concerning the products. The most important question is directed to the medical literature rather than the advertising or marketing campaign so common among marketdriven cosmetic products.

Fat Grafting: What is it?

What is fat grafting? Plastic surgeon Dr. Bryce Cowan explains this important rejuvenating options that is used both in restorative surgery (after a trauma) and for cosmetic purposes.

Face Aging: Decade by Decade

The upper, mid, and lower face all age as we go through the decades. Dr. Bryce Cowan explains how symptoms of aging typically manifest over time.

Ablative Laser Resurfacing – Postoperative Care

Wound care after laser skin resurfacing is critical for achieving a successful result. The superficial thermal injury created by laser skin resurfacing heals more quickly and with a reduced risk of scarring under occlusion. Effective management techniques can help minimize expected negative effects.

The Forehead Flap for Nasal Reconstruction: How We Do It

The forehead flap is a useful technique to reconstruct deep and large nasal defects. It can safely be performed under local anesthesia in an outpatient setting. Advantages of this flap include the fact that it provides an excellent color and texture match to the missing nasal skin.

The Use of Lasers for Decorative Tattoo Removal

We present our clinical experience along with literature findings on decorative tattoo removal and the important issues practitioners should consider in the management of tattoos.

Fat Rebalancing: The New “Facelift”

The fat compartments of the face undergo changes and are responsible for age-related alterations in facial shape. The overlying skin responds to changes in fat in much the same way as a garment clings or sags to the body underneath.

Cutaneous Cleansers

The choice of facial cleanser is important for people with normal skin, as well as for those people with sensitive skin and skin diseases such as atopic dermatitis and acne. Read this overview of all cleanser types for helpful recommendations.

Novel Flaps for Lip Reconstruction

Reconstruction of the lips requires careful attention to aesthetic and functional goals. We describe our approach to lip repair and present novel methods to maintain symmetry and function, and optimize cosmetic results.

Fat Grafting vs Synthetic Fillers

Synthetic fillers like hyaluronic acid are now incredibly popular to restore lost volume, like fat grafting. In this video we will compare the upsides and downsides of each procedure.

Dermal Fillers: Ever-Expanding Options For Esthetic Use

Aesthetic volume rejuvenation with dermal fillers continues to be a popular procedure that is sought by a growing number of patients who seek the rounder softer contours attributable to a more youthful appearance. This article will focus on the most popular, time tested, and innovative fillers available today.

Cosmeceuticals: A Panel Discussion About Educating the Public

The panelists for cosmeceuticals at Dermatology Update 2008 included 4 dermatologists: Jeffrey Dover, MD, Charles Lynde, MD, Catherine Zip, MD, and Jason Rivers, MD, who discussed cosmeceuticals and the role they play in current dermatology practice.

Soft Tissue Augmentation with Silicone

Adatosil® is a viscous silicone oil which was granted FDA approval in 1994. This designation removes the legal obstacles to usage for soft tissue augmentation. However, physicians are advised to exercise discretion when using this product.

Understanding Facial Aging: Non-Linear Aging Process

Why is it that some people (other people!) seem to age slower? It's not fair! Plastic surgeon Dr. Bryce Cowan explains the complexities and factors that affect the timeline of aging, in the first part of the Science of Facial Aging series.

Combining Chin-Jowl Implants With Local Anesthesia Facial Rejuvenation

Mandibular implantation is an outpatient procedure that can be used in combination with other minimally invasive cosmetic interventions. Specifically, silastic chin implants can help create a strong chin and smooth the jawline in carefully selected patients.

Lustra®, Lustra-AF® and Alustra™

Hydroquinone has been successfully used to treat hyperpigmentation for many years. Recently, new formulations containing hydroquinone have become available, including Lustra® and Lustra-AF®. These products also contain glycolic acid 2%, an active antioxidant system, and moisturizers.

What to Expect After a Fat Grafting Procedure

In this video Dr. Bryce Cowan explains what the patient should expect after a fat grafting treatment in terms of results, as well as the side-effects that patients can expect following the procedure.

Improved Skin Quality with Fat Grafting

Grafted fat is transferred as whole cells which are believed to contain stem cells that release cytokines and growth factors. This promotes a rejuvenative process in the surrounding skin.

Patient Research: How Would Patients Choose Their Surgeon?

Patients need to be able to both understand and accept the risks of surgery. It's a balance between their motivation and desire to undergo surgery and their willingness to accept the risks involved with that procedure.

The Process of Fat Grafting

We ask plastic surgeon Dr. Bryce Cowan about what patients should expect on the day of the surgical procedure.

Fat Grafting and Volume Loss of the Face

At what age do we start losing volume in the face, and in what areas? Plastic surgeon Dr. Bryce Cowan explains the process of volume loss with age, and how it affects the overall appearance of the face, and how fat grafting can help combat these changes.

Who Would be the Ideal Candidate for Cosmetic Surgery to treat Aging Face

The ideal candidate depends on the specific treatment, but in general terms, we are looking at a patient who is a healthy, non-smoker, does not have high blood pressure, does not require anti-coagulants, is in their late 40s or early 50s, where the impact of the surgery is highest.

How Long Do the Grafted Fats Last?

Typically grafted fats are long lasting. In this video Dr. Bryce Cowan explains how long fat grafts last in typical scenarios. The longevity of the grafted cells are one of the key selling points of this procedure.

The Cost of Treating Aging Face

Patients need to be able to both understand and accept the risks of surgery. It's a balance between their motivation and desire to undergo surgery and their willingness to accept the risks involved with that procedure.

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