At the recent Facial Plastic Surgery conference in San Francisco, there was a presentaion to the surgeons about a new type of canula to do the injections. Filler injections are routinely done with small needles, which accounts for the bruising, as the needle can nick a blood vessel as it enters the skin. The new canulas have a blunt tip, so that there is no risk of damaging a blood vessel and causing a bruise. As we incorporate these canulas into our practices, we should see significanly less buising than in the past — which is great news for our patients!

A surgical facelift is still one of the best ways to rejuvenate an aging face. As we age, volume is lost, and many of the tissues will start to descend. This causes jowls, and a flattening of the cheek area. When we are young, there is a triangular shape to the face, which turns into more of a rectangle as we age. With a surgical facelift, the cheek fat is moved back up, and the neck and jaw skin tightened. This helps to re-establish the triangular shape. Excess skin is excised, and deep support sutures are placed to hold everything in an uplifted position. This surgery is done in the office with local sedation anesthesia. Most people have some bruising and swelling for about 10–14 days. Pain is minimal. Attached is a photo which demonstrates the return of the youger shape to the face after a facelift.

In a traditional lower eyelid blepharoplasty the fat is removed from the lid. While this may look good initially, with time the lid and eye will often appear hollow with very dark circles. A much better approach is to move the fat down into the tear trough. By preserving the fat, the tear trough gets filled in and the dark circles will dramatically decrease. This can be done on the inside of the eyelid so that there is no external scar.

If a patient does not have much fat in the lower eyelid, fat can be transferred to the lid from another area on the body. Liposuction is done in the abdomen or hips, the fat is processed, and then injected into the lower lid. This fat will fill in the tear trough, and help to plump up the skin so it will appear less wrinkled.

PRP has been used for many years in orthopedic surgery. It is injected into a joint after surgery to help decrease inflammation and speed up healing. PRP is obtained by drawing blood from the arm. The blood is then processed, and the PRP is separated and saved. It has a high concentration of platelets, growth factors and stem cells which account for its’ healing benefits.

In cosmetic surgery, PRP has been injected under the skin at the end of a facelift procedure. Surgeons report that this decreases post-op bruising and swelling and helps with the healing process. Cosmetic fat transfers have also become very popular in the last few years. In addition to adding volume to the face, the fat has a large store of stem cells which are theorized to be responsible for the improvement in the appearance of the skin tone and texture which is seen after the fat transfer. Adding PRP to harvested fat should provide additional stem cells and growth factors to create additional rejuvenation.

With PRP injections into the face, the growth factors and stem cells should help to improve skin tone and texture. But it does not add volume which is often an important aspect of facial rejuvenation. It is also not known how long the effects of PRP injections will last. For these reasons, I think fat injections are a better option for facial rejuvenation, especially in a patient who has lost any volume in their face. Hopefully clinical studies will be done in the future for PRP injections so we will have a better idea of the results that can be expected.

A recent study done in the Netherlands shows that women are more prone to perioral (lip) wrinkles than men.  There may be several reasons for this.  Compared with men, women’s perioral skin contains fewer sebaceous and sweat glands.  This could influence the natural filling of the dermis. Their lip skin is also less vascularized (fewer blood vessels), which could accelerate the development of wrinkles.  And the muscular fibers surrounding the opening of the mouth are closer to the dermis, which might cause an inward traction, or pulling, creating deeper wrinkles.

Fortunately, there are many mini-procedures to choose from that can help minimize or even eliminate these unfortunate lines. From laser and IPL to Juvederm or fat injections, we have a solution to make your lips smoother and more youthful again. Give us a call at 305.444.5950 to see how Dr. Martin can help your lips look their best!