Dr. Andrew Jacono

We primarily use liposuction to contour the jawline and neck.  It’s a relatively simple procedure with a three to five day recovery.  Doctors can use any style--laser, the old style, fiber optics, it all works. But, it’s not good to use liposuction on other parts of the face where it causes irregularities and puckering.

Stand in front of the mirror and lift your forehead. If you like the way it looks, you need a brow lift. Some people have heavy foreheads—it has to do with genetics.  Sometimes patients think they need eyelift because their upper eyelids look heavy, but they really need a forehead or brow lift, not an eyelift.

One that’s performed with small incisions in the hairline, instead of making large cuts. We make poke holes the size of a drinking straw.  They are hidden in the scalp and don’t cause problems with hair growth.

Yes they can, but it’s more complicated.  We make a cranial large incision over the top of the forehead, and then lift everything up, bringing all the tissues forward. Then we use tacks and anchor the forehead and brow in a lower position.  It’s hard to make it go back to its regular state.  It’s a much-more extensive surgery.

If it’s not a dropped forehead or brow, we make a small incision in the eyelid and remove the extra skin.  It’s a very small procedure.

There are different ways.  The non-surgical way is to use filler—like Restalyne or Juvederm— in the deep hollows under the eyes. We do a surgical procedure not commonly performed: Fat transposition lower blepharoplasty. It’s like filler, but we use the natural fat from around the eye area, not from elsewhere in the body, and fill in the deep hollows. It’s a very strong, effective procedure.

It depends upon the patient.  There are so many techniques for rhinoplasty, and each technique is not the used for everybody.  We try to minimize incisions and do a “closed” rhinoplasty, where the incision is made on the inside of the nose, but it’s not for everyone.  In an open rhinoplasy, there is a small external scar.

We do chemical peels, but it’s all about laser resurfacing.  We have so many lasers.

With a liquid facelift, we use materials, or fillers, to revolumize the face and fill in grooves.  It’s like re-inflating a balloon.  They give the skin a lifted appearance, but are non-surgical.  All it takes in 10 minutes and you look great!

It depends on what you are trying to accomplish.  Hyaluronics can be used all over, but last a shorter period of time, six to eight months. They work superficial lines and wrinkles better. Radiesse lasts over a year. It’s designed to be more supportive because it’s made form bone particles.  Sculptra also is long-term. It lasts two to three years. It helps the body create its own natural collegen, but you need two to three sessions.

For lips, the best are hyaluronic materials.  The other types of fillers can cause nodules in the lips. I use Juvederm for lips the most.

I don’t use it, but some doctors are good at it.  The problem with silicone is that a small percentage of people can have a bad reaction to it.  You have to cut it out if you have a reaction to it.

There shouldn’t be, generally speaking.  It usually goes away after a week.  I usually don’t break nasal bones (which is what causes swelling and bruising).  There are newer techniques. Some surgeons do it a lot because that’s what they are used to, and what they are comfortable with.

A mid-facelift usually lifts the cheek area and rejuvenates droopy cheeks and nasalabial folds.  It is usually performed without a large incision, endoscopically through the hairline (scalp) or eyelid.  A full facelift usually involves a relatively hidden incision behind the ear.  A full facelift deals with the Cheek area, jawline, jowl, and neck areas—it works on all of the face.  There is a more visible incision, but when done properly it is well hidden.

Generally speaking we use something to fill them, like hyaluronic acids, or we use lasers to smooth them out. The fractional CO2 laser resurfaces the best with the least amount of color changing to the skin. It’s used to smooth out lines and wrinkles of the face.

It is extremely safe. It lifts slightly and gets rid of the lines and wrinkles caused by flexing facial muscles by relaxing them. It makes the face look refreshed and the eyes look more open and less tired.

They do it all the time.  Sure.  As you get older you droop and you deflate.  You lose volume and natural elasticity.  We use fat to augment these areas—like in the cheeks, hallows under the eyes and around the mouth—and rebuild the natural heart-shaped face.  We borrow fat from other parts of the body. It’s also referred to as a stem cell facelift because fat has stem cells and properties beyond filling things—it can lift and revolumize at the same. If the fat “takes,” it’s permanent.  But doctors have to be honest with patients: 30 percent of them time it doesn’t take and needs to be repeated.  But we do everything we can to make sure it takes.   It can be frustrating, but it is still a very good treatment.

There are so many different materials.  It depends on the patient’s facial structure. Different materials can be customized.  And some come in different shapes and sizes.  The most common are Silastic (which is silicone), Gortex, and Porex.

With a neck lift, which is actually a face lifting procedure. We can also use Ultherapy (a non-invasive device that uses focused ultrasound energy to lift the skin on the face and neck). It’s a new treatment that is about 30 percent effective. It tightens, but doesn’t treat the problem entirely.

I use it all over: For neck bands, for a gummy smile, lifting a downturned mouth, etc.