Cosmetic Dermatology

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

Debunking Common Misconceptions about Aging Process

What cosmetic procedures might be useful for a given patient? The two key principles of aging of the face are volume loss and tissue malposition. There are many elements changing simultaneously, so it's very rare that there is an effective singular procedure that can act as a fix all solution.

The Surgical Correction of Protuberant Ears

While prominent ears are considered a sign of good fortune in the Far East, Western society looks upon prominent ears in a far less positive manner. Children with prominent ears are often the subjects of verbal and at times physical abuse by their peers, resulting in adverse psychological effects.

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.

Botox, Injectable Filler, and Cosmetic Surgery to Treat Aging Face

What cosmetic procedures might be useful for a given patient? The two key principles of aging of the face are volume loss and tissue malposition. There are many elements changing simultaneously, so it's very rare that there is an effective singular procedure that can act as a fix all solution.

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.

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.

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.

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.

Face-Lifting: An Overview

Numerous adaptations of face-lift techniques have been devised, and each surgical approach has its own risks and benefits, as well as proponents and detractors. All of the conventionally accepted techniques achieve removal of redundant skin.

Advantages of Cosmetic Surgery when Treating Aging Face

What are the advantages of cosmetic surgery over soft procedures like Botox and dermal fillers? The main advantage is that cosmetic surgery allows for a more profound and long lasting correction that's not possible with other treatment options.

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.

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.

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.

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.

Cosmeceuticals: A Practical Approach

The cosmeceutical industry has undergone phenomenal growth over the past decade. Acquiring a basic knowledge of the major classes of active ingredients that are found in cosmeceuticals will enable healthcare professionals to provide accurate and educational information to consumers.

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?

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.

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.

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.

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.

Update on Botulinum Toxin

Botulinum toxin type-A (BTX-A) is a neurotoxin which blocks presynaptic release of acetylcholine. It interferes with neuromuscular transmission, temporarily paralyzing the affected muscle. Of special interest for dermatologists is the unlabelled cosmetic applications, for conditions such as wrinkles and hyperhidrosis.

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.

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.

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.

The History and Safety Record of Fat Grafting

In terms of history, fat grafting has been used in medical circles for almost a century. In recent decades, however, new research and innovations in technique have improved the success rate of fat grafting significantly.

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.

Unfit Candidates for Cosmetic Surgery

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.

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.

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.

Plasma Skin Regeneration Technology

Plasma skin regeneration technology uses energy delivered from plasma rather than light or radiofrequency. Plasma skin regeneration technology can be used at varying energies for different depths of effect, from superficial epidermal sloughing to deeper dermal heating.

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.

Blepharoplasty: Indications, Outcomes, and Patient Counseling

A telltale sign of the aging face is upper eyelid skin redundancy and lower eyelid bags. These changes can contribute to a “tired” appearance. Upper and lower blepharoplasty procedures can correct these processes. By removing skin and muscle, an upper eyelid blepharoplasty can give the eye a larger appearance.

The Cost of a Fat Grafting Procedure

What is the cost of fat grafting compared to injectable fillers? Plastic surgeon Dr. Bryce Cowan explains that it depends on the timeline, the patient’s age, and what they are looking for. Fat grafting is initially more expensive compared to fillers, but has greater longevity by a wide margin.

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.

Rejuvenation of the Lip with Injectables

As the range of soft tissue augmentation products proliferates, most will be used (with varying degrees of success) to shape and augment the lip. This review will discuss some of the factors that should be considered prior to injecting a lip with soft tissue augmentation products.

Adjunctive Skin Care for Acne (Pharmacist Edition)

Acne is among the most common dermatological disorders seen by dermatologists, affecting approximately 85% of people between the ages of 12 and 24 years. The use of adjunctive cleansers and moisturizers can help mitigate treatment side effects and subsequently enhance therapeutic efficacy.

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.

Male Aesthetics

Men are a fast growing segment of the aesthetic industry. This article discusses important gender differences in facial anatomy and behavior that are relevant, as well as the requirement for different injection techniques when using dermal fillers and Botulinum toxins.

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.

The Process of Fat Grafting

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

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