Positive Energy

Positive Energy

Radio Frequency Skin Tightening

By: Beth Phillips,RPAC

Radio frequency (RF) technology used to tighten skin and remodel tissue is one of the most exciting modalities that I have seen in the aesthetic plastic surgery industry in quite some time.

The medical team at our office frequently attends conferences to learn about and to be aware of emerging technologies that allow us to best provide our patients with options to achieve their goals. This past year, I attended a very prestigious conference and there was an entire forum dedicated to a technology that has existed for a long time, but is now being made available to use in a safe and very effective way.

What is Radio frequency energy? Radio frequency energy is an electrical energy that transforms to thermal energy when introduced to tissue. This stimulates sub-dermal collagen production, thus causing tightening of the surrounding tissue. RF energy produces an electric current in contrast to laser-based energy that produces energy via light. This minimizes tissue damage and does not affect melanin in the skin. This means that RF energy can be used on all skin types and allows for different depths of penetration based on what is being treated.

As a practitioner, I am always looking for ways to optimize the results that we can achieve for our patients. I found this to be a modality that treats a patient population that we often would send away and tell them to come back when things got worse. Common areas like neck, jowls, arms, bra rolls and inner thighs are places that patients frequently complain about. There are surgical corrections for these that will provide great improvement but leave a scar and have associated down

time. If there is enough laxity in these areas, surgery may still be the best option, but for what I call the “in- betweeners”, I think this is a great option. Instead of excising tissue, a small knick is made in the skin to allow for a probe to be placed under the skin. The radio frequency device (in our case, it is Bodytite or Facetite by Inmode) has an attached probe above the skin, fashioned similarly to a tuning fork, that sends RF energy between the two probes. There is a computerized feedback mechanism that will turn the machine off if the temperature becomes dangerously high to the tissue being treated. The only resulting incisions are less than one centimeter.

Early results are seen immediately, but continued collagen formation will create ongoing improvement for approximately one year.

Another modality where RF technology is used is called Fractional micro-needle radio frequency (FMR which is Fractora by Inmode in our office). Our aestheticians already perform a very large volume of micro-needling procedures with excellent skin improvements. FMR provides greater potential collagen production. It also is used successfully in the treatment of hyperhidrosis of the axilla. Sweating of the underarms, palms and feet can be greatly improved and sometimes eliminated with radio frequency micro-needling.

Radio frequency assisted lipolysis (RFAL) is liposuction that employs RF to improve the outcome by tightening the skin as well. This works well for male gynecomastia as well as areas such as knees, inner and outer thighs, pubic mound, arms and abdomen. The Bodytite platform is essentially “smart lipo” which is a term used for

liposuction where fat is Liquifed before it is suctioned out. This has traditionally been performed with a laser. The risk of burns from the laser is higher. With RFAL, or as we call it “Smart-ER lipo,” the computerized feedback largely eliminates the risk of burns.

RF technology has so many applications in the plastic surgery and aesthetic setting. There is too much information to provide in one article. Attached is one website that contains videos and research supporting the technology. https://inmodemd.com/

As the final article that I will be writing for Women of Upstate New York Magazine, I would like to send my best wishes to Mary McCandless in her retirement. It has been a very enjoyable and satisfying experience to be able to share information about what we do at CNY Cosmetic and Reconstructive Surgery. I have met so many wonderful women via this publication.

I thought that “Positive Energy” was a good title for my last article. I believe that the message that Mary has been sending to her readers about “Making Ordinary Women Extraordinary” is a message that should NOT be retired. My first appearance in WOUNY was in an article where I was asked my favorite quote. The quote by Robert Ingersoll, ‘We rise by lifting others,” continues to be my favorite. Even though my articles focus on ways to improve your outward beauty, I continue to believe that true beauty comes from within. From all of us at CNY Cosmetic and Reconstructive Surgery, we applaud the positive energy that “Women of Upstate NY Magazine” has cultivated over the years!!

WOUNY • SEPT/OCT 2018

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HAND REJUVENATION

BEAUTY

By: Beth Phillips, RPAC

Most of us have heard the saying, “If you want to know a woman’s age, look at her hands.”

Well, I say, ‘Not anymore’!!

These days, people are doing more to camouflage their age. Many people exercise and take better care of their bodies. There are countless products and procedures that help to maintain a younger appearance. Neurotoxins (Botox, Xeomin, and Dysport), fillers, laser treatments and surgery are among the most common. It has become increasingly difficult to distinguish someone’s age.

Your hands don’t have to give away your secrets anymore.

There are several procedures aimed at giving the hands a more youthful look.

This past year, Radiesse, a dermal filler, gained FDA approval for injection into the hand. Radiesse is made of calcium hydroxylapatite (CaHA), which is a substance found naturally in human bones. The CaHA is suspended in a gel carrier and when injected, provides immediate volume to the areas in which it is placed. It also stimulates collagen production in these areas for long-term improvement of the skin. Other fillers ( such as Juvederm or Restylane) are used in hands to provide the same result, but are used as an “off label” indication because it has not yet received FDA approval.

Some physicians prefer fat grafting to the hand for a rejuvenating technique. Fat is taken from the body via liposuction. It is then re-injected into the hand. There are pros and cons to fat grafting over dermal fillers. Fat is more permanent, but when

placed, it is less reliable to tell how much will stay. Fat can feel lumpier and will change size if you have weight fluctuations.

Either way, adding volume to the hand minimizes the appearance of blood vessels seen and makes skin look less wrinkled.

Another common procedure to rejuvenate hands is the use of lasers to smooth the pigmentation on the skin and eliminate dark spots. (Dark spots are often referred to as “liver spots” but truly have nothing to do with the liver!). Broad-band light (BBL) or intense pulsed light (IPL) are simple office-based procedures with minimal discomfort and virtually no downtime that will cause these spots to fade significantly or disappear completely.

Chemical peels and micro needling procedures improve the overall skin texture and integrity. By decreasing the appearance of fine lines and aiding in stimulation of new collagen production, these are quick procedures that provide very nice results.

Also worth mentioning, but much less commonly performed, are sclerotherapy and skin excision. Sclerotherapy is used to cause prominent and unsightly blood vessels to collapse. Skin excision can leave scars.

As always, with your skin, use of sunscreens and limiting UV ray exposure to the affected areas will keep your rejuvenated hands looking more youthful for years to come.

Be sure to know the credentials of anyone performing these procedures. The procedures discussed are extremely safe and

satisfying when performed by an experienced and properly trained professional.

If you would like to learn more, contact CNY Cosmetic and Reconstructive Surgery 315-663-0112.

Over the years, we have been blessed to have Beth Phillips of CNY Cosmetic & Reconstructive Surgery share many great stories about what we can do to look and feel better. We are all subconsciously critiquing our bodies and wondering what we can do to change it, and Beth has provided tons of information to help us to make educated decisions. Her stories give men and women options and here are some of those stories. Remember, you can read all the stories on our website by going to our “current or previous issue” tab and clicking on the issue.

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WOUNY • SEPT/OCT 2018

Bro-tox

By: Beth Phillips,RPAC

One of the many increasing trends in male plastic surgical procedures is Botox (or other neurotoxins such as Xeomin or Dysport) injections. Laughingly referred to as Bro-tox, this procedure is used to soften wrinkles in the face.

In 2015, a study from the American Society of Plastic Surgeons (ASPS) showed that the number of men receiving injections increased by 337 percent since 2000.

While most women get Botox injections to look younger, most men seem to get Botox in order to stay competitive. Dr. Daniel Mills, president of the American Society for Aesthetic Plastic Surgery stated, “They’re simply having more procedures done because they want to maintain competitiveness in an increasingly ageist workplace.”

In our office, we have seen a huge increase in the number of men that are interested in plastic surgical procedures. Botox, or “Bro-tox”, is one of the most common.

Many, if not most men come in at the urging of their significant others. I would estimate that almost half of my male patients have had their first visit along with their wives or girlfriends. Sometimes they start as observers, but many times they become regular customers on their own.

Botox, Xeomin and Dysport are all considered neurotoxins and work by blocking the neurotransmitter acetylcholine, thus causing temporary paralysis of a targeted muscle. It is injected in very small aliquots using a small gauge needle in the areas deemed appropriate by the practitioner. The onset of action usually is seen within a couple of days, but can take up to two weeks to see the full effect.

Botox lasts approximately 3-4 months and then must be repeated in order to maintain the desired effect.

These injections are most commonly used to treat wrinkles in the glabella (commonly known as “eleven’s,” “frown lines” or “devil’s horns”), forehead and around the eyes. It is also used in the treatment of sweating. It can be injected in the palms of your hands, soles of your feet, or underarms to eliminate or at least greatly diminish perspiration in these areas. To be complete, I should mention that there is another area that botox has been reportedly used...also with a catchy name. “Scro-tox”, as you might have guessed, is botox injections to the scrotum. This has been cited as being effective for the treatment of both

wrinkles and perspiration.

While Botox injection has become one of the most common male procedures in our office, there are still many other cosmetic procedures for the guys.

Other common procedures that our male patients have performed: facial fillers, liposuction, Sculpsure (non-surgical fat reduction), tummy tucks, facelifts, neck lifts, male breast reduction, PRP for hair loss, laser treatments for facial veins or toenail fungus.

Men have become more comfortable with coming in for aesthetician services such as facials and chemical peels.

With June being the month in which Father’s Day is celebrated, I thought it would be appropriate to mention that the male equivalent to the “Mommy Makeover,” now termed the “Daddy does-Over,” is further evidence that the guys don’t want to be left out! Cosmetic procedures are not just for women anymore and have become very commonplace for men.

Learn more at www.plasticsurgeryofsyracuse.com 315-663-0112

“Eye”

want to look as young as

I feel!!!

Often in my business, women

come to me and complain that they feel younger than what they see in the mirror. Expressions like “The eyes are the mirror of the soul” or “Your eyes are a reflection of your spirit” often cause women to be distressed because they feel that they are still vibrant and yet a multitude of factors may leave their eyes looking more tired and aged than they are. The topic of improving the under eye skin is commonly discussed in the plastic surgeon’s office.

The topic is difficult because there are so many factors to be considered. The skin under our eyes is most often the first area where signs of aging appear. Most women know that a lack of sleep or a day of excess sodium intake can dramatically affect the look of their eyes.

There are many problems that can be addressed. Puffiness, dark circles, and wrinkles are some of the most common complaints. Patients come into the office and hope that there is simple a cream or injection or even procedure that will make these area look years younger. While there are modalities that help, the best thing to do is to protect the skin in the first place. Proper hydration of the skin both internally and externally by drinking plenty of water, avoiding excess amounts of caffeine and alcohol that tend to dehydrate you.

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WOUNY • SEPT/OCT 2018

By: Beth Phillips,RPAC

Keeping allergies under control and using anti-histamines to shrink swollen vessels and tissue. Avoiding sun damage by applying a daily sunscreen to the skin under the eyes and wearing sunglasses when in direct sunlight. Avoiding smoking is a must.

Unfortunately, heredity often plays a significant role in the appearance of a person’s under eyes. In these cases, we need to look for treatments instead of just good habits. For fine lines, retinoid creams are helpful as a maintenance regimen. Botox is often another first line fix for under eyes. By placing Botox in the muscles that cause the skin to wrinkle thousands of times a day (as people often do with facial expressions), it allows the skin to rest and be less “worn” in its appearance.

Ablative lasers are often used to resurface the under eye skin, and IPL can be used to help with dark pigmentation.

Dermal fillers such as Volbella, Belotero, Restylane and Voluma can be used to help fill in areas that have lost volume. These fillers need to be placed at an appropriate depth to avoid further discoloration caused by a phenomenon called the Tyndall Effect. Fillers in this area should be placed by someone with significant experience with treating under eyes. Most of the injections in this area are considered “off label,” but can be placed safely using the proper

techniques.

There is also a surgical procedure called a lower blepharoplasty that can be performed to improve the lower eyelid. This procedure is performed with either an incision that runs just below the lower lash line or one inside the lower lid.

The traditional blepharoplasty has an incision that runs along the lower lash line. Fat is removed or repositioned, and skin is removed. Sometimes muscles and/ or ligaments are tightened-this is called a canthopexy. Alternatively, a trans conjunctival blepharoplasty involves an incision inside the eyelid with fat removal or repositioning without the removal of skin. There is also another procedure called a pinch blepharoplasty that removes less skin and is usually performed in conjunction with laser resurfacing.

Rejuvenation of the under eyes is possible with varying results, and the treatment is often multi-factorial to achieve the optimal result. As always, a consultation with a qualified professional is always the first step to implementing a skin-care regimen that best suits your needs.

For more information about this and other services, contact CNY Cosmetic and Reconstructive Surgery at 315-329-6602 and visit our website plasticsurgeryofsyracuse.com