The Importance Of Facial Anatomy Knowledge In Your Injector


“No two faces are made the same”- I imagine some evolutionary scientist stated this at some point.

Myself and our other injectors here at Marvel Cosmetic Surgery have found this to be true recently at a SCALE facial anatomy course presented by anatomy guru, Dr. Cotofana.

We study anatomy and physiology, we watch training weekly on products, preventative and corrective injections, and we share ideas and successful tips between each other- but we now stand out as injectors because we have learned new ways to identify important blood vessels and anatomical features of your face.

This all starts with the consultation and assessment process and highlighting the importance of appreciating ethnic and gender differences as well as the unique features each face holds. There are three 3D aging changes that happen in our faces starting in our childhood years.
As you prepare to have neuromodulators (i.e. botox) and fillers administered to prevent/correct these effects, it is crucial your injector and yourself understand these.

Photoaging affects your collagen and elastin fragmentation manifesting in your appearance as fine lines and wrinkles.
Fat loss is the redistribution of deep and subcutaneous fat over temporal, deep malar, mandibular, and preauricular areas. These changes manifest as nasolabial folds, infraorbital hollows, and jowls.
Bony changes such as loss of bone in the pyriform area weakens support of the lateral crura and deepening of the maxilla resulting in posterior positioning of the nasolabial crease and adjacent upper lip (volume and support loss around mouth).

After our most recent cadaver course, we were able to bring home injection techniques around preventing these changes and correcting them at their root rather than filling the lines continuously, costing our patients more visits. For example, the two most common areas our patients desire filler are under eyes and lines around the mouth. By proper injection of a high G-prime filler into the cheeks and SOOF, we can provide our patients with a more effective lift and correct multiple areas with one injection. This is only one example of the impeccable techniques each of our injectors hold in their knowledge bank.

Come in for a complimentary aesthetic consultations about toxins and fillers to enhance your features from the root!

By Brittany Best

What You Should Know About Liposuction

Excess fat doesn’t just give the body a terrible look. It also puts people at risk of developing other serious health complications. As good as dieting and exercise may be, they are not enough for some fat deposits. Over the past years, liposuction has gained tremendous popularity in the skin health sphere.

What is Liposuction?

As opposed to the misconception of many, liposuction is not a weight-loss procedure. It is a cosmetic surgery that removes fat from the body. The popular cosmetic surgery option is otherwise called ‘lipo’ or body contouring. If you are considering removing excess fat from your thighs, hips, neck, abdomen, underneath the chin, or any other body part, you may want to consider this treatment option.

How Does Liposuction Work?

First, the surgeon makes an incision in the skin to allow access to areas of fat.  Next, a fluid is injected into the treatment area to – anesthetize and break up fat cells. Afterward, a small tube called a “cannula” is inserted into the incision. Suction is used to remove the fat deposits.

Benefits of Liposuction?

Liposuction has several benefits:

Safe Removal of Fat: The safe removal of fat is probably the lead factor responsible for liposuction’s fame. Provided good hands perform the surgery and you adhere strictly to all post-surgery treatments and recommendations, lipo safely removes fat from the body.

Permanent Removal of Fat Cells: Lipo removes fat cells permanently. Once the fat cells are removed, they will not grow back. However, losing fat cells in one body part doesn’t mean you can’t gain fat in another. Therefore, it is important after liposuction to keep a close eye on your weight to stay in shape.

An Improved Appearance: Having excess fat on some body parts may be cause embarrassment leading to low self-esteem.  Liposuction can help you have that killer look that you desire.

Conclusion

Liposuction will make a great treatment option for fat removal.  I recommend that you book a consultation with me to know if it is a good fit for your skin and overall health status. Also, ensure to keep to all post-treatment advice to avoid complications or worsening side effects.

By Dr. Jefferson

Post-Op Recommendations For The Brazilian Butt Lift (BBL)

 

The Brazilian Butt Lift or BBL is an increasingly popular procedure which involves the transfer of the patient’s own fat into their buttocks in order to augment the size and shape of the buttock instead of using implants. Typically, the fat is removed or harvested from the patient’s abdomen, flanks (sides), and lower/mid back. Once all of the fat is collected, it is carefully injected into the buttock until the desired result is achieved. The BBL has become one of my favorite procedures to perform because it is challenging, and I enjoy surprising my patients with a life changing result. This blog will attempt to list some common post op recommendations and hopefully better prepare patients for their future BBL.

 

  1. Post op visits – Patients will usually be asked to return for post op visits at 2 weeks and 8 weeks after surgery. Sometimes we need to see our patients more frequently, but the majority will only require these two visits.

 

  1. Restrictions – We recommend that our patients not sit or lie directly on their buttocks for 3 weeks after surgery. During this time, they should sleep on their stomach, stand for all activities, and refrain from sitting as much as possible except for using the toilet. Patients will be allowed to sit normally after 8 weeks.

 

  1. Time off work – Most patients will need anywhere from 1-2 weeks off from work. However, we prefer that patients plan on taking 2 weeks off if possible.

 

  1. Compression – Patients are sent home with a compression garment specifically designed for patients having a BBL. I will usually recommend that my patients use this garment for the first 2 weeks. After that time, I will recommend they purchase a new compression garment that will be slightly smaller as the patient will usually have shrunk in size from liposuction. I recommend searching on Amazon for a “Colombian faja” for BBL. I’ve attached a link below to one of many examples on Amazon:

 

Amazon Colombian Faja for BBL

 

  1. Massaging – We recommend that patients attempt massaging as soon as possible in order to achieve the best results from their procedure. The first few days will be difficult due to the pain, but the goal should be to massage at least 3 times a day for 30 minutes each. I usually recommend that my patients make an appointment with a massage therapist for at least one visit in order to see how a professional performs the massage. You can google a nearby therapist that offers lymphatic massages. Make sure you inform the therapist that you recently received a BBL with liposuction before booking the appointment. Most patients are able to perform their own massages or will have a friend or significant other that can help. Youtube is also great resource to help find lymphatic massage techniques and tips specifically for liposuction. I’ve attached a link to one of these videos below:

 

Youtube Lymphatic Massage

 

 

  1. BBL pillow – We encourage our patients to purchase a BBL pillow to help them avoid excessive pressure on their butt during the first 8 weeks after surgery. These can be purchased on Amazon. I’ve attached a link below as an example:

 

BBL Pillow

 

  1. BBL float/chair – For patients that normally sleep on their back, I will recommend that they purchase an Avocado float that will allow them to sleep on their back while also supporting the butt while avoiding excess pressure. Another option is to purchase an outdoor folding chair and cut out a hole for the butt to fit through so that there is no pressure when sitting. Lastly, there is also an inflatable chair that is specifically made for BBL patients. I will add Amazon links for all of these options below:

 

Amazon Avocado Float for BBL

 

Amazon DIY chair for BBL

 

Amazon Inflatable Chair for BBL

 

  1. BBL forums – Lastly, there are many forums available online specifically meant for patients having a BBL procedure. These are great resources for patients to find additional information, support, and recommendations. We always encourage our patients to use this resource if they find it helpful, but we are also available to assist with any questions if needed.

 

I hope this information was helpful. Please call our office if you have any additional questions and to book a free consultation for your future BBL!

By Dr. Noah

What is Rhinosculpture?

Rhinosculpture is new procedure developed by Dr. Gerbault of France. This procedure is also referred to as Ultrasonic Rhinoplasty by some. The procedure uses piezoelectric technology which has been around for 20 years and used mostly in dentistry. Special miniaturized hand pieces have been developed for exclusive use in rhinoplasty. The piezo device differs from other powered instruments by vibrating in the ultrasonic frequency thereby generating very little heat. It is selective to hard tissues such as bone, sparing the soft tissues such as skin, muscle, nerves and blood vessels. This results in less bruising, swelling and thermal trauma which translates into faster healing. Rhinosculpture allows the surgeon to precisely reshape the nose that is too wide, uneven, or has a hump. The bone is gently sculpted by using a polishing technique rather than rasps and chisels which were developed over 100 years ago. Using the old instruments the bones were broken blindly with less precision and predictability. Sometimes the bones would not break or heal as planned and lead to unexpected cosmetic results requiring revision surgery. The added precision of piezosurgery allows surgeons to obtain a more perfect result with a smooth feeling afterwards. The bones can be sculpted very accurately to reshape the nose to the desired result. We are excited to be able to offer Rhinosculpture to our patients.

By Dr. Jeffrey Marvel

Breast Implant Location: Above or Below the Muscle

Breast augmentation with implants is one of the most commonly performed cosmetic procedures in the United States.  Not only does augmentation surgery increase breast size and fullness, it also enhances self image.  Patient satisfaction is extremely high after augmentation surgery.  The results are noticeable immediately!!

 

During the consultation, the surgeon and the patient discuss expectations, implant types, and select implant sizes.  Most importantly, a physical exam is performed and measurements are obtained.  The surgical plan is customized for each patient. 

 

I frequently encounter the question regarding implant location: subpectoral (under the muscle) versus submammary (above the muscle).  In the subpectoral position, the implant is placed partially or completely under the pectoralis major muscle.  In the submammary position, the implant is placed completely above the pectoralis muscle but below the glandular breast tissue.

 

Neither position is universally the best!! Implant location is based on each patient’s breast anatomy. Factors that play a role include:

 

  • skin quality (thick vs thin)
  • current breast size
  • desired breast size
  • breast shape
  • breast ptosis
  • nipple position

 

Measurements of nipple position that were obtained during the consultation are important when selecting implant location.  When the nipple remains centrally located on the chest wall without a significant amount of breast ‘droop’ or ptosis a sub-muscular position is best.  However, once your nipples have descended and there is moderate to severe ‘drooping’, implant position above the muscle is best.  This avoids what is called a waterfall deformity or what some refer to as a “snoopy dog breast deformity”.

 

If you are interested in breast augmentation, I recommend you schedule a consultation so that we can discuss the best options for you.

 

Dr. Jefferson

Labiaplasty vs Vaginoplasty

Labiaplasty and Vaginoplasty are the two most commonly performed procedures within the scope of female genital cosmetic surgery, also known as cosmetic gynecology. Although these procedures are very different, I have noticed that they can cause some confusion with patients. For example, these separate procedures are often mistaken for one inclusive surgery or are mistaken for an entirely different type of surgery such as a prolapse or incontinence surgeries. My goal is clear up this confusion and hopefully help my patients make a more informed decision whether they are suitable candidates for either, both, or none of these procedures.

 

There are many reasons why patients may elect to have either of these procedures. One reason can be strictly cosmetic, meaning that the patient views part of her genital area to be aesthetically displeasing and wishes to improve the appearance.  Other reasons include functionality purposes such as discomfort in clothes or while participating in activities such as running or walking. Lastly, these procedures can be performed to help improve sexual satisfaction or function.

 

Labiaplasty focuses on the external part of the vagina and vulva. The goal of this procedure is to reduce the size of labia minora or less frequently labia majora. This is done by surgically removing any excess skin on the outside of the vagina. The incision is then closed with absorbable suture.

 

Vaginoplasty focuses on the internal part of the vagina. The goal of this procedure is to restore the vagina in women who suffer from decreased vaginal sensation or feelings of a loose or wide vagina which can affect their sexual lifestyle. Vaginal relaxation whether it’s due to aging, prior vaginal births, or trauma is improved by decreasing the diameter of the internal vaginal canal. This is accomplished by surgically removing excess vaginal tissue and tightening the underlying muscle layers with absorbable suture.

 

I hope this information was helpful. Please contact our office to schedule a free consultation where I can answer any additional questions and discuss which treatment option would be best for you!

 

By Dr. Noah

Cosmetic Surgery Procedures To Consider This Winter!

 

Now that the seasons are changing, I’ve had lots of patients asking me: “What time of year is best for cosmetic surgery?” That’s an especially good question this year, because COVID has everyone’s holiday plans up in the air, and since everyone is wearing masks all the time.

The Winter is always a good time for any kind of surgery since it’s cooler, and you can wear baggy/bulky clothes to conceal your swelling and bruising. But some procedures are especially good to do in the winter.

This year, eyelid surgery is great any time of year. Everyone is wearing masks, so their eyes are all that most other people see.

Upper eyelid surgery is a quick procedure with very little downtime – Reagan at our Spring Hill office had hers done yesterday (Thursday) and has a full day scheduled next Tuesday. Since it’s cool outside, she’ll have less bruising and swelling than if she had her surgery in the summer, and she won’t miss any fun outdoor activities since the days are so short now. Chin implants, lip lifts (check out this excellent article – https://www.allure.com/story/lip-lift-plastic-surgery-procedure ), and facelifts are also great procedures to do now, because your mask will hide your swelling while you recuperate!

Any kind of body contouring surgery (liposuction, breast lift, breast augmentation, tummy tuck, and BBL) is great to have during the Winter. First of all your recovery will be a little easier because of the cool weather and your ability to hide your swelling under sweats. Second, most people are a bit more sedentary in the Winter, so resting during your recovery is a little easier. Finally, and maybe most importantly, November through February are a great time to have breast augmentation, tummy tuck, liposuction, and BBL, since you’ll be totally recovered and ready to wear your swimsuit when the pools open in April!

by Dr. Ingram

Brazilian Butt Lift

The Brazilian Butt Lift, or BBL, is one of the fastest growing cosmetic procedures in the country. Just in 2012, only about 8,500 such procedures were done in the US, compared to over 34,000 in 2019. More than any other procedure, its growth has been fueled by the rise of social media. However, along with its exponential growth, there have been concerns over its safety, with some preliminary studies labeling it as having “the highest mortality among cosmetic surgical procedures.” 

 

Although there have indeed been cases of mortality related to the BBL in the US and the rest of the world, newer studies have demonstrated that using proper technique significantly reduces the risk to levels comparable to other cosmetic procedures. If you are interested in a BBL, in addition to asking about board certification, you should have a frank discussion with your surgeon about his or her training and experience doing the procedure, their assessment of the risks and mortality associated with it, and the measures they will take to minimize these risks.

 

The most important one of these measures includes injecting the fat over the gluteus muscles, but there are many others, such as those proposed by the Multi-Society Gluteal Fat Grafting Task Force or the World Association of Gluteal Surgeons. Just like with any other consultation, your surgeon should instill confidence not only in his or her ability to provide you with a great cosmetic result, but also with performing the procedure as safely as possible. 

 

By Dr. Morales

My Favorite Procedure

 

As a cosmetic surgeon in practice for nearly 30 years, I have found rhinoplasty to be my favorite operation.  Hardly any surgery gives patients more satisfaction than a well planned and executed rhinoplasty procedure.

This procedure is something they and everyone else sees every day for the rest of their lives.  So the stakes are high.  Sometimes the slightest alterations, which are preferable to drastic changes,  can make the biggest impact and produce safer more reliable results.  My favorite cases in particular are young female patients who are very attractive but feel self- conscious about their nose.  One frequent comment I get a lot is “I got my daddy’s nose!”  Often times they do not have a feminine nose to match their face.  When the nose fits in harmony to the face one can appreciate the overall beauty of the face, rather than the eye being drawn to a flawed feature like a large nasal hump.  From the surgeons stand-point, the rhinoplasty procedure is a life-long learning procedure.  It is the most difficult surgery to master.  When I get the result that I am striving for, and have a happy patient, then it makes all the hard work and years of study worth it all.

By Dr. Marvel

Tummy Tuck FAQs

Tummy tucks – also known as abdominoplasties – are one of the most common procedures performed by cosmetic surgeons. Tummy tucks have become more popular not only because of the dramatic results most patients show but also because of our focus on health and fitness. Recent advances in the operation offer better pain control and a smoother recovery. Here are a few of our patients’ most common questions about this operation.

“Do I need a full tummy tuck, or can I have a smaller scar – for example, with a “mini” tummy tuck or just liposuction?”

 

Every tummy tuck is slightly different, since everyone’s problem areas are different. Some patients have too much loose skin, some have lots of stretch marks, some have too much fat, and some people’s muscles been stretched or separated by pregnancy. People with tight skin can benefit from procedures which result in reduced scarring approach, such as liposuction, an endoscopic abdominoplasty, or a mini-abdominoplasty. If there is a lot of loose skin that needs tightening, you will require a longer scar. We always try to keep scars as short as possible, but what matters most is how your skin and waist look after surgery, since tummy tuck scars are hidden under shorts and a bathing suit.

Will a tummy tuck help my stretch marks?”

Absolutely. After pregnancy, most women’s stretch marks are below their belly buttons, and this is the skin that is removed in a tummy tuck. Unlike lasers and creams (which I don’t think I have ever seen help anyone at all, once they’re a year out from having their last baby), an abdominoplasty completely removes this skin, making your entire abdomen look like the much less damaged skin between your ribcage and your belly button – but even better, since even that undamaged skin is stretched and looks better than before!

“How much discomfort will I have after a tummy tuck?”

Years ago, tummy tucks were frequently performed in hospitals, and many patients could not stand straight up for a week or two. We perform all of our tummy tucks in one of our two outpatient surgery centers, so our patients are up and walking on the first night after surgery. Most patients need 3 or 4 days of a mild narcotic pain reliever and are back to their normal light activities about two days after they stop taking pain medicine. People who had had a prior C-section say that the discomfort is a 2-3 if the C-section pain was a 10.

“How long is the recovery after a tummy tuck?”

The answer to this question depends on what you mean by “recovery.” All our patients are walking around their homes on the first day after surgery. Most people are able to get out of the house for light exercise and shopping (but NO HEAVY LIFTING) on the third or fourth day after surgery. You can drive a car about a week after surgery, and you can start lower body aerobic exercise (a recumbent stationary bike is the best at this stage) at ten days after surgery. After that, it is up to you and how you feel, but you can’t lift anything heavier than 30 pounds until a month after surgery because we don’t want anything to mess up the muscle tightening you’ve gotten.

“Will the results last?”

Absolutely! As long as your weight remains fairly stable, abdominoplasties are usually a ‘one and done’ procedure, which does not need to be repeated. Of course, your skin will continue to age after surgery, but it almost never gets back to the looseness that you had before surgery.

“After pregnancy, my tummy needs help, but my breasts do, too. Can you work on both at the same time?”

Absolutely. Lots of patients have changes to both their abdomen and their breasts after childbirth and nursing. Combining abdominal and breast contouring after pregnancy is so common that it has a name – “mommy makeover.” Combining these procedures makes a lot of sense, because you save a little money on the operations and can combine your recovery times, making it easier to fit both operations into your hectic schedule.

By Dr. Ingram