Dr. Vitenas

It is important to understand the difference between Botox, a muscle relaxer, and Restylane, Juvederm, Radiesse, and other fillers. If someone has a line that is apparent only when making an expression, Botox is often all that is necessary to correct it. Botox can be used to treat such lines on the forehead, around the eyes, around the mouth, and the chin area. Fillers are used to fill deep creases in the skin that remain even when the face is at rest. They also can be used to improve or enhance facial structures such as cheekbones, lips, noses, hollows under the eyes, jaw lines, acne scars, or to improve balance in the face. As we age, we experience a loss of volume in the face, particularly apparent in thin people and those who spend a lot of time working out. This becomes a catch-22, in the sense that the people who have spent the most time taking care of their bodies often look older in the face than those who are more sedentary.

Many times, if creases have already been softened with Botox, smaller amounts of filler can be used, such as in the area between the eyebrows. When Botox accompanies filler in the lips, many people find their filler has a longer duration. We frequently have patients who complain of dark circles or hollows under the eyes. This is caused by loss of the fat layer due to a natural downward pull of the cheeks as we age, and can be remedied by the precise placement of an appropriate filler. Addition of filler in the midface area not only instantly refreshes the face; it can replace the mid-facelift giving a much more natural look. This is not to say that injections can always replace surgery. There will always be cases that require a full facelift to give the desired outcome.

Combination therapies can yield amazing results, literally taking 10 or more years off a person’s face instantly. These treatments are always individualized, depending on natural facial structure, skin elasticity, and the patient’s own wishes. In the hands of an experienced injector, thoughtful combinations of Botox, Juvederm, Radiesse, Restylane, Prevelle Silk, and Evolence can be used to take ten years off of your appearance in a matter of an hour. This approach to facial rejuvenation is deserving of the term “Liquid Facelift” as it addresses the signs of aging before you need the knife!

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Tags: Liquid Facelift, Botox, Restylane, Perlane, Juvaderm, Radiesse

The Cosmetic Surgery Edge
Posted July 08, 2008 1:35 PM

Government statistics indicate that an increasing number of people are seeking cosmetic surgery in an attempt to get ahead or maintain their position in the workplace. Unfortunately, in these competitive times, age discrimination is all too common. But it is not just older people looking to become more competitive with their younger colleagues. It has become almost a rite of passage for young men and women to have a corrective/enhancement procedure done at the beginning of their careers to increase their potential value to prospective employers. Good looks are associated with good health, and a potential employee’s good health gives employers confidence in their work ethic.

Patients seeking cosmetic surgery consultations, regardless of age and gender, may hope to gain self-esteem and confidence by altering physical characteristics, thus making themselves more competitive in the eyes of future employers. This is much more basic than the pressure to look perfect in a world obsessed with beautiful celebrities. Procedures that include male gynecomastia correction, otoplasty, female breast enhancement/reduction, rhinoplasty, facial liposuction, chemical peels, facial fillers, and labiaplasty are among procedures that can enhance a young person’s sense of self worth and confidence, allowing them to focus on what they are intellectually able to offer future employers.

Many patients will ask, “Do I need plastic surgery?” Plastic surgery is an elective procedure and nobody needs it, however many people want it, and after having it find that they have improved not only their happiness and self-esteem, but their potential worth in the eyes of employers. Financing options, such as Care Credit, can allow immediate improvement in one’s appearance. Much like higher education financing, these loans become an investment in the future. Of course, adolescent candidates for cosmetic procedures should be at least 18 years old, and procedures should be delayed until patients have the emotional and physical maturity to make an informed decision.

Anita Vennekotter RN

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Tags: Cosmetic Surgery, Botox, Restylane, Juvaderm, Radiesse, Plastic Surgery

With all of the options available now, how do I choose the best facial filler?
Posted May 08, 2008 8:59 AM

We choose appropriate fillers following skin analysis and medical history, and based upon whether we are attempting to soften facial creases and lines, restore/create volume and fullness, or smooth uneven texture caused by scarring. Today we have filler choices that can be very temporary, such as human-based collagen, and others that can last from one to several years, including highly cross-linked hyaluronic acid, calcium hydroxylapatite, and polymethylmethacrylate. Often, these fillers are layered to improve results. There are many new fillers on the horizon, so the options will be even greater soon. The placement and choice of filler to be used should always be individualized and your injector should be knowledgable, experienced, and have a good eye for balance and beauty.

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Tags: Facial fillers, injectables, Restylane, juvaderm, Radiesse, Sculptra, Artifill, perlane, Juvaderm Ultra Plus, Evolence, puragen

What is Vaginal Rejuvenation, and how do I know if I need it?
Posted May 08, 2008 8:55 AM

Many women are dissatisfied with the external appearance of the vaginal area. Vaginal rejuvenation refers to several different procedures which can be performed alone or in combinations. Aging occurs from head to toe. Both the natural aging process and childbirth can contribute to a loss of elasticity and tone in the vaginal canal which can result in lack of sexual pleasure. Vaginoplasty is a quick in-office procedure to remove excess vaginal tissue, decrease the size of the vaginal opening, and repair other supportive tissues in the vagina. Labiaplasty is a surgical procedure to reduce or reshape the labia minora and/or labia majora. In woman of reproductive age, there is considerable variation in the size of the labia. In some instances, women with large labia can experience pain during intercourse, or feel discomfort during everyday activities, especially when wearing tight-fitting clothing. Other women may feel unattractive and embarrassed. After the procedure most women have less discomfort during intercourse, feel more positive about their appearance and show overall improvement in their self esteem. Perineoplasty restores and tightens the lower portion of the vaginal opening to further enhance labiaplasty results. Women who have unsightly fat deposits in the pubic region can benefit from pubic liposuction. These fat deposits may have been present since birth or acquired with weight gain or puberty. Clitoral hood reduction can be performed for women who are bothered by the size of the clitoral hood and the clitoris shaft or head (glans). The hood may protrude too much causing the woman to be self-conscious or irritated. This is often performed as part of a routine labiaplasty.

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Tags: Vaginoplasty, Labiaplasty, Vaginal Rejuvenation, Pubic liposuction, perineoplasty, labia minora, labia majoria, clitoral hooding

My wife tells me that I need Botox, but do men actually have it done?
Posted May 08, 2008 8:46 AM

Men are just as concerned about their appearance as women, and in these competitive times, looks are about more than vanity. A man's looks are linked to his job-related connections, his financial wealth, and to his happiness. Botox is one of the safest and most effective cosmetic treatments available for facial rejuvenation, and the convenience of BOTOX® treatments has made it a popular cosmetic option for men. Aesthetic treatments for men don’t just stop at Botox. Men have a growing interest in cosmetic treatments and procedures in general, from simple chemical peels to full face and body lifts. Facial fillers are popular among men, as well as skin tightening and Lipodissolve.

Statistics available from the American Society of Aesthetic Plastic Surgery show that surgery is becoming increasingly popular with men as a way to deal with image maintenance and change.

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Tags: Men, Botox, Fillers, Cosmetic Treatments

Choosing the best place to have injectables.
Posted April 30, 2008 2:59 PM

How do I choose the best place to have injections of Botox and fillers done?

All medical treatments have potential risks, and cosmetic injectable treatments are no exception. Reducing your risk of potential complications requires that you:

1. Recognize that injectables are medical treatments and belong in the hands of a trained physician or highly trained nurse injector, and that getting a good result requires a real artistic eye of the injector.

2. Do not act on impulse when you choose injectables. Follow proper procedure by learning about your injector’s experience and the treatment you will have.

3. Accept that there is no such thing as a “generic” or “substitute brand” for U.S. FDA-approved injectables.

4. Be aware that “too-good-to-be-true prices” may be an indication that you are not getting a U.S. FDA-approved injectable or an appropriate dosage.

5. Do not accept treatments at a party, public gathering, spa, salon or other non-medical setting.

If you follow these recommendations you will have an excellent chance of obtaining a beautiful result.

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Tags: Botox, Injectables, Fillers, Injectors, Natural Results

Mesotherapy vs Lipodisolve
Posted February 28, 2008 8:41 AM

What is the difference between Mesotherapy and Lipodissolve?

Lipodissolve is body-sculpting by injection, targeting pockets of fat that do not respond easily to diet and exercise alone. It is a non-surgical alternative to Liposuction for the right candidate, but does not replace surgery for everyone. Often, Lipodissolve is confused with Mesotherapy, when in fact they are two different procedures. Mesotherapy has been used for 50 years in Europe medically and aesthetically, while in the U.S. Mesotherapy is mainly used aesthetically as a cellulite treatment. The skin is nicked with a very short needle, allowing the combination of ingredients to enter just the dermis and the top of the subcutaneous tissue, where fat cells and tough connective tissue contribute to dimpling of the skin. It is the only known permanent solution to cellulite. Other technology can only temporarily stretch connective tissues to give a short-lived smooth texture.

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Tags: lipodissolve, body-sculpting, injection, mesotherapy

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