The Most Commonly Asked Questions About In-Office Procedures, Answered

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This article first appeared in the Winter 2019 issue of NewBeauty. Click here to subscribe.

From aligners to veins, here’s what readers want to know from NewBeauty’s top doctors.

I’m starting to notice tiny white bumps around my eyes. What are they, should I be concerned and how can I fix them?
“White bumps can be a few things. Milia are the most common, which are basically little white heads. When they occur, they can be extracted by a dermatologist. Good skin care and Retin-A, routine facials and peels are all things that can help prevent them. Sometimes people have other white bumps around their eyes called syringoma. These tend to be hereditary and can increase with time. The best option for removing those are direct excision. Always check in with your doctor if you notice anything concerning—sometimes these white bumps turn out to be cancer.” –Largo, FL oculoplastic surgeon Jasmine Mohadjer, MD

I want a rhinoplasty surgery to reduce the size of my nose, but I’m concerned it will impact the rest of my face. Will it change any of my facial proportions?
“Rhinoplasty surgery can affect the aesthetics of the whole face. The proportions of the nose affect how everything else on the face appears, especially the eyes and chin. When the nose has been changed to better aesthetic proportions for a particular face, the nose will disappear when looking at the face, the eyes will be brighter and the whole face will instantly appear more attractive. If the nose is tenting the upper lip up due to a large nasal base and this is improved with the surgery, the appearance of the upper lip will improve and have more normal mobility.” –Scottsdale, AZ facial plastic surgeon Kelly Bomer, MD

I want to get a facelift, but I’m only in my early 40s. How can I tell if I’m ready or even a candidate for surgery?
“Although the average age of a facelift has remained stable at roughly 57 years old, advances in surgical techniques have opened the door for younger people to get excellent results with very small-scar, mini-facelifts starting as early as their 30s, and have also become safe and viable for people in their 80s and beyond! For me, the question to any potential patient becomes, ‘Does your desired level of improvement require surgery, or can we approach your goals nonsurgically with lasers, peels, injectables, etc.?’ If surgery is warranted, I make sure they are the right candidate by asking a few important questions. Someone ready for a facelift has realistic expectations—meaning they understand that the best possible facelift restores roughly 10 years; is emotionally stable—facelifts are powerful and can likely trigger lots of emotions, so the right candidate should be supported enough to sail through them; can afford the downtime; and chose our practice because they specifically like what we do and our aesthetic, as we want to be certain that what we deliver satisfies their expectations.” –Dover, OH facial plastic surgeon David Hartman, MD

I want more youthful-looking eyes, but I’m not ready for major surgery. Are there any good (and safe) nonsurgical treatments to help me not look so tired all the time?
“Aging changes in the eye area can vary from hollowness, fines lines and wrinkles, excess skin and prolapsed fat. It’s important to identify the exact aging changes a person has, and then target those areas. If you’re not ready for surgery, some options include neurotoxins, fillers, lasers and microneedling. However, the newest technology that addresses the upper and lower eyelids, as well as the brows, is AccuTite, which utilizes radio-frequency energy to melt fat, tighten skin and build collagen. This is the latest in nonsurgical rejuvenation around the eye area and can provide good results with minimal downtime.” –Windermere, FL oculoplastic surgeon Keshini C. Parbhu, MD 

I inherited my mother’s blue eyes, but also her varicose veins. Are there any treatments to help get rid of the veins?
“There are multiple causes for varicose vein formation, including pregnancy, obesity, prolonged standing and family genetics. While varicose veins are unsightly, they can cause significant problems if left untreated. Chronic swelling, discoloration, pain and ulceration are common long-term effects of dilated abnormal veins in the legs. It is important to determine the underlying cause of the varicose veins to find the best treatment possible. However, there are many treatments to reduce the complications. Initially, compression stockings help reduce pain, swelling and further issues. More permanent treatments include sclerotherapy injections, endovascular ablation and surgical removal. Addressing the swollen veins early, with the help of a vascular specialist, can eliminate most or all of the long-term complications. Exercise improves blood flow, which can prevent varicose vein formation. Conversely, crossing legs or cutting off circulation can exacerbate it.” –Orlando Park, IL plastic surgeon David A. Dreyfuss, MD

I’m in my 30s and want to fix my teeth. Do clear aligners work as well as metal braces? And how long before I can expect results?
“I have treated hundreds of patients with Invisalign aligners, and the results are excellent as long as the patient is compliant and wears them continuously, except when eating. Each case is unique, however, the length of treatment and cosmetic results for Invisalign and traditional braces, either metal or clear, are generally the same. For those patients with severe malocclusion, Invisalign may not be the appropriate course of treatment and traditional braces will be indicated.” –Miami cosmetic dentist Jan L. Ziegler, DDS

My skin feels “squeaky clean” after I wash my face. That’s a good thing, right?
“It’s a misconception that your skin should feel tight after cleansing. Actually, that ‘squeaky clean’ feeling is a sign that your skin is lacking the necessary oils that help keep it soft and healthy. You may get that feeling after washing if you are using a cleanser or soap that contains ingredients that strip away and break down the acid mantle layer—the protective barrier that shields your skin from external damage. When this protective barrier is compromised, skin can begin to show signs of inflammation and irritation. Instead, it’s best to use a cleanser that is gentle and hydrating so that the skin feels comforted after a good cleansing.” –Chicago dermatologist Dr. Quenby Erickson

Are there any powerful facial treatments that are best done during winter?
“It is always best to do most facial treatments on skin that has not been exposed to the sun, and best not to have any tan at all. Treating tan skin can effect the outcome and potentially cause discoloration, burns or scarring. For this reason, I always discourage treatment during the summer months unless my patients are motivated and willing to use lots of sun protection—always broad-spectrum SPF 30, which defends against both UVA and UVB rays.” –Tenafly, NJ dermatologist Sharon Scherl, MD

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