Dr. Min S. Ahn

By adding volume with a injectable filler, or by adding volume using their own body fat taken from under the belly button. We process it, and place in cheek. Often, it's a combination of a lifting technique to move the jowls upward, and a fat transfer. Cheek implants are not as popular these days.

The way you avoid the 'pulled look is to make sure you are doing most of your work underneath the skin layer. With a facelift or a mini facelift, you lift the skin after you make the incision. Surgeons used to just pull the skin. The modern lifting technique also involves lifting the muscle layer underneath the skin layer. It's a more natural look that lasts longer. If the skin is pulled too hard it will give you a pulled look as well. We move things more vertically rather than moving them straight back. Otherwise, it gives the patient a windblown look.

The Dual Fraxel laser is extremely effective for treating brown spots. The IPL (Intense Pulsed Light Treatment) and also topical agents containing Hydroqunone also minimize brown pigment; but they only work on superficial pigmentation. If the patient tries these treatments and they don't really work, then the pigment is deeper and you need to use a laser instead like the Dual. You can use the fractionated laser on any skin service. It's very effective for the decollete.

I treat laugh lines with filler. I prefer Juvederm Ultra Plus, which is a longer-lasting version of Juvederm. Others use Restalyne or Perlane, and some others use Radiesse. It's really the doctor's preference.

We try to treat it medically first with topical agents like topical antibiotic therapy, like MetroGel, or Azelaic acid, which is used to calm down the redness and to control acne associated with it. Often those don't work all that well. Then we can use a pulsed dye laser called V-Beam ('V for vascular). It works, but takes multiple treatments, three to five separate treatments, given about a month apart, and there is typically a fair amount of bruising after each treatment.

Through one of two approaches: One approach is 'closed, and the other is 'open. 'Open rhinoplasty involves a small incision across the base of the nose bridge between the two nostrils. It lets you see all the structures underneath. In either case, it involves a structural approach with close attention paid to maintaining the tip and the bridge of the nose, so you will have a long-lasting esthetically pleasing nose. Years ago, a reduction approach was used which involved taking away cartilage and soft tissue. This caused the nose to lose structural integrity, and over time the nose would collapse or move. Making it look natural is most important. This involves manipulating cartilage at the tip, along with cartilage and bone of the bridge and various combinations.

About eight years.

If it's the lower face and neck, about three hours; if it's just the lower face, then two hours. If you do the eyes and brows, too, then it would take four-and-a-half hours or so.

Not with Radiesse and not with Sculptra. Yes, with hyaluronic acid fillers as long as you're not allergic to bees. The enzyme that breaks it down is actually in bee venom.

That's true with BOTOX for frown lines, forehead lines and crow's feet. Treating them early on will prevent wrinkles in the future. It's not so true with fillers. It also does apply to fractionated laser treatments. Women who have had a series of treatments before they start seeing sagging or creases will have skin that holds up better over time. Think of it as preventative maintenance.

To be honest, people don't complain about pain, but they feel sore primarily located around the ear and if doing neck work, in front of neck and underneath the chin. Eye surgery tends not to hurt much at all. Scarring is dependent on the technique used. There are ways to minimize scarring in the design and how the closure is performed. The lift incision can be a straight line in front of the ear and that leaves a more noticeable scar, or it can be a series of short curves that follow the contour behind the ear, which makes it more discreet. There is a movement now toward a shortened incision that ends at ear the lobe or in back of the ear crease, instead of extending across the back of ear and into hair in back of the neck.

You can use both. It depends on the wrinkle, and upon the time you have to recover. With a fat transfer you will have a surgical recovery.

In terms of facial surgery, macs lifts allow for a quicker recovery because the incisions are shorter. Patients are put into a light sleep, so there is no general anesthesia required. This short-scar facelift procedure removes excess skin and tightens underlying facial structures. When we combine a macs lift with a necklift, we can achieve dramatic and long-lasting results, without making long incisions.

I think that's an old term, but most would say it includes the brows, eyelids, lower face and neck.

A Fraxel laser is a brand of fractionated laser therapy, where instead of an entire layer of skin being threated all at once with side effects--the laser columns are separated from each other so you are treating a fraction of the skin surface with each treatment. Because you are only treating a fraction of that skin surface, and the in-between skin in not being treated, the skin heals quicker and safer. The key is that you are still getting collagen formation throughout the whole skin surface area or dermis, and not just in the single area where you created that small hole.

It's just a way of focusing on the neck. Some people only have extra neck skin and banding, but not jowl, so a small incision is made underneath the chin, with a j-shaped incision around the ear lobe on both sides. The key with any kind of neck lift is we to have to work on the two bands of muscle, the platysma muscles. A platysmaplasty sutures those two bands together to make the neck smoother.

It's a term used to describe a specific procedure where a crease is purposefully created in an eyelid that doesn't have a crease. About 50 percent of Asians are born with some sort of crease, and those Asians who don't have them naturally want to create a crease to make their eyes look more open and attractive. The key is that it has to look natural.

Called the 'mask of pregnancy, it's a chronic skin condition characterized by patches of brown pigment across the cheeks, nose, forehead, upper lip and chin; often associated with hormonal changes during pregnancy or from the use of oral contraceptives. It is a chronic problem and can get worse with sun exposure. It's a challenging problem to treat, honestly, but we can try topical agents like Azelaic acid or Hydroquinone. Fractionated lasers can be tried but there is always chance that it can recur. It's different than spots caused from too much sun.

Some type of volumizer, whether in the deep crease in front of jowl or by adding volume to the cheeks to make you look more youthful. Hyaluronic acid filler is the most common class of filler, such as Juvederm or Restylane. The difference is Juvederm has a different manufacturing process and has a higher degree of cross-linking, so it is more of a smooth gel and it lasts longer, a year to year and a half. Restylane is more particulate and lasts about six to nine months. A different class of filler is Radiesse, which is made of calcium hydroxylapatite, and is used for creases and folds. Hyaluronic is something we have in body, whereas Radiesse is a white paste. Both add volume and fill in folds, but Juvederm and Restylane can be dissolved if you don't like the way it looks. Radiesse can't be dissolved, so you have it for a year even if you don't like it. Radiesse also can't be used in areas with thin skin, like the lower eyelid tear trough area.

By far the best treatment is BOTOX or Dysport.

Non-fractionating, or ablative, lasers were the original lasers from 10 to15 year ago that removed the superficial skin surface all at once.

There are two main Fraxel lasers are called Dual and the Repair. The Repair is used for tightening and to smooth out fine lines and wrinkles. The Dual is used more for refreshing of the skin by stimulating collagen and clearing out brown pigmentation or sun damage. The Restore was the original Fraxel that has since been upgraded to the Restore/Dual. The Erbium laser is what was first used, and when it was upgraded to the Dual, they added a second laser called a Thullium laser, hence the 'Dual because it incorporates two lasers that work at two different levels. The Erbium builds collagen, while the Thullium clears out pigment. The Repair uses a carbon dioxide laser which is a stronger laser. It does not just heat up tissue, but vaporizes it and causes more surrounding heat which makes the recovery longer.

The recovery is usually 10 days. Stitches, if there are any, come out at one week. The tip and bridge of the nose will still be swollen for about the first two weeks. Contrary, to popular belief, it's not a painful recovery. It's only painful if packing is used, which most modern surgeons don't use any longer.

Traditionally, they were treated with surgical scar revision or dermabrasion; but these days most would agree the fractionated laser is the best treatment. The CO2 Fraxel Repair laser is the best or a series of Fraxel Dual/Restore treatments. They work best on depressed acne scars (versus narrow, deep icepick scars). The important thing is to manage the patient's expectations; it's not going to be perfect even after treatment. At best, they can expect a 50 to 75 percent improvement, but most are very happy with that.

Hyaluronic acid fillers. Most would agree that Juvederm Ultra is best for the lips.

One of the hyaluronic acids. I prefer Juvederm, but some prefer Restylane. Radiesse cannot be used, nor can Sculptra, under the eyes.

Someone who has had results they are not happy with, and who has realistic expectations in terms of what improvement can be achieved and how good the ultimate outcome will look like. There is more scarring and longer recovery with revision rhinoplasty because something has already been done to the nose that didn't work out quite so well.

Sculptra in generally used for larger areas that have lost volume, and it takes a while to get to the final state. You need three treatments, four to six weeks apart, so it takes you about 12 to 18 weeks to get to where you want to be. Some people want something more immediate. There are also some areas you can't use Sculptra, like in the tear troughs and lips. If you have laugh lines and that's all you want to fill, Juvederm works immediately and lasts a year-and-a-half, so it would be a better option if you want to fix it today.