Dermal Filler Dos.

lyzahLyzah, Registered Nurse

Dermal fillers are used to correct volume loss in the face.  We can use these in cheeks, lips, tear troughs, temples, nasolabial folds, jaw line, ear lobes,chin… almost everywhere really.  When injecting dermal fillers, there are several guidelines I like to share with my patients to help them to achieve their best possible outcome.

First, I like to advise patients how to prepare to receive the injections.  I suggest that you discontinue the use of Aspirin, Fish Oil, and Vitamin E supplements 10 days prior.  This does not mean you can’t have filler if you took Aspirin that day or the night before.  It simply means you may experience some bruising associated with the blood thinning effect of these products.  I would also recommend taking Arnica (homeopathic for bruising) and Bromelain (homeopathic for inflammation) tablets 3 days prior (continue for 7 days after).  Again, if you don’t, it is not a deal breaker.  You just may experience more bruising and swelling.

Next, I like to give my patients a realistic idea of what to expect.  Many fillers are temporary hyaluronic acids that your body will eventually absorb naturally between 6-12 months.  Initial treatments, may require a ‘touch-up’ in 4-6 months to prolong results and/or increase volume for best results. This also depends on which product and how much product you choose initially.  The initial volume with Sculptra (polylactic acid) will diminish after the first 3-5 days. PLLA particles will then work to stimulate your own collagen to replenish lost volume. It is then important to follow up every 6-8 weeks until you achieve ‘FULL correction’ with this product. I stress that it is common to have swelling, redness, and even bruising after treatment. Following the instructions above and icing the area can help diminish one’s chance of experiencing these undesirable side effects.

Lastly, I recommend that you avoid direct exposure to heat and sunlight, excessive manipulation and rubbing of the treated area(s) for 48 hours, chemical peels and laser treatments immediately after.   Apply ice to the treated area(s) for the first 48 hours as well as Arnica cream and continue taking your Bromelain.  I also recommend drinking plenty of water for the next 5 days as this will help hyaluronic acid to ‘hydrate’.

I welcome my patients to call me if they have any questions post procedure.  This will help me when administering your next treatment.

Is filler permanent?

lyzahLyzah, Registered Nurse

Myth 3: “My filler will last forever, right?”

The honest answer to this question is NO they will not last FOREVER with only ONE treatment. Dermal fillers are fillers that treat volume loss in most areas of the face including lips, nasal labial folds, chin, cheeks, tear troughs, under eyes, jaw line and  temples.  Most hyaluronic acid fillers (Restylane, Perlane, Silk, and Juvederm) will last anywhere from 6-12 months with one treatment. However; if you can tolerate minor maintenance about every 6-8+ months, you can achieve and maintain amazing results that last.   Keep in mind results also depend on which filler you choose, what area we treat, and how much product we use. The most common filler complaints I have encountered are a result of inadequate amount of product being placed.  Perhaps you needed 2 syringes and chose to place only one syringe, you may not achieve your optimal result. For this very reason I am all about consultation and catering to each patient’s needs and what will work best for your lifestyle. Another hyaluronic option is Juvederm Voluma, specifically for cheek volume. With adequate treatment you can expect to see results for up to 2 years. The last option is Sculptra Aesthetic, or poly-L-lactic acid (PLLA). This is also a filler used to add volume; however, in a few days the initial volume diminishes, and the PLLA microparticles remain to stimulate your own collagen production. With adequate treatment you can expect to see natural results for 2-5 years. I strongly recommend you consult with your practitioner and ask plenty of questions prior to having a treatment. This will help to eliminate any confusion, and also aid in the selection of type and amount of product that best fits YOU.  :)

Toxins and Fillers and the Holidays! Plan Accordingly…

It’s Holiday party season, are you ready?

This time of year we see a rush of patients refreshing their Dypsort/Botox and Filler to look their best in time for all of the Holiday parties. So, for those who are new to the game, I wanted to help you plan your treatments.

Botox/Dysport are so commonly used today that this may be unnecessary, but these are used to soften lines on the forehead, between the eyes and on the sides of the eyes (crow’s feet). The treatments themselves really only take a minute or two. Small amounts are strategically injected to soften and smooth out unwanted wrinkles and lines. But, because of the injection itself, you can get a bruise or a little swelling. Also, neither product works immediately. Dysport works more quickly but you wont see its full effect for about 4 or 5 days. So I would recommend treating about a week before your event.

The fillers, Restylane and Juvederm are the most widely used, are used to plump. They are commonly used on tear troughs, cheeks, nasolabial folds, and lips. Now, the effects of the filler are immediate, but again you can get a bruise and everyone gets some amount of swelling with fillers. So, again I would recommend you treat about 1 week before your event.

I hope this information helps you plan. Be sure to check our website at www.corbettcosemticsurgery.com for our Holiday specials!

Lee Corbett, MD

Medical Director Corbett Cosmetic Aesthetic Surgery and Med Spa

Filler Myths

lyzahHi I’m Lyzah your personal Registered Nurse/ Expert Injector. (More so expert injector than Registered Nurse, I must admit.)  Like if someone needs life-saving medical intervention I’m probably not your girl, BUT if you want a FABULOUS face I’m THE girl. I love love love what I do! Part of that love is helping others look and feel like their best self (which I think go hand in hand).

Originally from Virginia, I attended The University of Kentucky and started my nursing career in dermatologic skin cancer surgery (MOHS) at a practice in Ohio. Basically, our practice specialized in extensive skin cancer treatments of the head and neck. I learned from what I consider to be the best surgeons in the business, and am so glad I had those years of experience. I then moved back to Louisville and worked mostly with general Dermatology before switching to the amazing cosmetic side. Combining all that I have learned over the years is why I think I’m a great artist. I really think this business is about true artistry and getting to know your patients well. I want all of my patients to enjoy coming in to see me, feeling like I give them personal attention at each visit, and MOST of all helping them look and feel their best. Too often I hear about bad experiences and bad results; as a result, patients are often too scared to do anything. This leads to my latest blog topic ‘Myths and misconceptions about fillers’.

Over the past few years Injectable Fillers have dramatically increased in popularity. They are most commonly used to treat fine lines, wrinkles and facial volume loss.  According to the latest statistics from the American Society of Aesthetic Plastic Surgery, cosmetic dermal filler treatments have increased by 8% in the last year alone. What makes them so appealing is their ease of use and noninvasive alternative to surgery with fantastic results. However; as popularity has grown, many myths and misconceptions have also developed.

Myth 1:   “Am I going to look like Joan Rivers, or those crazy celebrities on TV?”

My favorite line I use with my patients is “you are going to look like yourself, only better”. My goal is not only making you look better, but also feeling great about yourself. I don’t ever want anyone to leave our office feeling unnatural or overdone. One way I achieve this is taking the time to discuss with my patients exactly what bothers them, and what outcome they are trying to achieve.  I carefully explain each option and what will work best for them.  In all, fillers can be very natural and easy with the correct techniques and injector.  It’s truly all about catering to each patients needs and what will work best for their lifestyle.

So what are Fillers?

Fillers represent the single largest growth sector of aesthetic medicine over the past few years yet I don’t think a lot of people know what they are or how they are used.

So here’s Filler 101. Most of the fillers out there today, Restylane® and Juvederm® are the most common ones, are composed of Hyaluronic Acid (HA). HA is a protein that is already all over your body. It’s in your skin and joints and connective tissue. HA’s have replaced Collagen injections because they last longer and are easier to use. The longevity of the fillers varies but tends to be many months at least with some of them lasting several years.

Uses: Fillers fill and that’s how we use them. They are not intended to smooth fine lines or crows feet or frown lines. That’s what the toxins do, think Botox® and Dysport®. Fillers restore volume to your face. As we age, our faces loose volume, particularly our midface. The mid face is the area between your lower eyelids down to the bottom of your nose. What happens is the fat pads we have in that area tend to shrink and descend. So, with the fillers we can safely restore that volume. It’s that simple.

Now, fillers can be used all over the face and commonly are. We inject them in the temple, between the eyes, in tear troughs, the nose, cheeks, nasolabial folds, marionette lines, lips and along the jawline. They are very versatile.

The lip injections are what most people see and they are the reason, based on the comments I hear from women, that some patients shy away from fillers. Some patients prefer a larger lip that some others may see as being “over done”. This is really a matter of opinion but the point is, if you see a patient with a very full lip or cheek or wherever, it’s because they like it that way. They have simply requested more filler. You don’t automatically get huge lips just because you inject some filler. Some patients request 1 syringe ( 1cc) of filler, others 3 or 4 syringes.

Fillers are injected in the office usually with topical anesthesia. The whole process takes about 30 minutes. After, you can have some swelling, or bruising and the area may be a little tender for a while. Overall there is very little down time associated.

So there’s a brief summary of fillers. If you are interested or have more questions please just contact our office. 502.721-0330.

Lee Corbett, MD

Medical Director of Corbett Cosmetic

Preparing for your plastic surgery consultation…

I met a very nice patient a few days ago and we had a very different but very fun type of consultation. She was a 40ish lady and wanted to know what could be done about her face. The thing is, she couldn’t really tell me what she didn’t like, she just knew she “looked older” and didn’t like that part. She wanted me to analyze her face and help her figure it out.

Sooooo…off I went and we broke down every aspect of her face from top to bottom. We found a couple of minor issues that were easily addressed with a little Botox® and a couple of syringes of filler and she left the office happy BUT with some homework before her next visit.

Her ‘homework’, and I would recommend this to anyone before their facial aging consultation, was to sit down in front of her makeup mirror and simply make a list of what she saw that she didn’t like. I also asked her to do this with a photo in hand of her when she was in her mid 20’s so she could compare and really see what changes had occurred.

If you can give your plastic surgeon a very specific, detailed list, we can offer a list of “fixes” starting from easiest/least complicated up to surgery and that way you can decide which approach you want to take.

Lee E. Corbett, MD

Corbett Cosmetic Aesthetic Surgery and MediSpa

The misunderstandings about fillers…

About every other day I have someone ask me why so and so looks the way she does or why the celebrity of the day has “lips like that”? What they are questioning is the look you can get when you add a lot of filler, such as Restylane® or Juvederm®, to the lips or cheek areas. Usually it’s the lips.

Well, the thing is, it’s not the filler and it’s not the injector, at least not in my office, it’s the patient who is directing this. When we inject filler what you see is what you get right on the spot. Now in the day or two after you may have swelling or bruising that can slightly alter what the real result is, but that is transient. So the point is, when you see someone with really full lips, that you might think are overly plumped, well, they are that way because she wanted them that way. We don’t make that decision for the patient.

When we inject filler we have the patient there with mirror in hand. We treat and then have her take a look. If she likes what she sees we stop. If she wants more, we add more in small amounts until she is pleased. It’s that simple. So don’t be afraid of filler!  Fillers are GREAT products and are actually the treatment that is growing in popularity by the day. If you only want a mild to moderate correction/enhancement that is entirely possible.

Fillers are your friend!

Lee Corbett, MD

Medical Director Corbett Cosmetic Aesthetic Surgery and MediSpa

What are fillers and what can they do for me?

Basically, Fillers are injectable treatments that we use to help restore facial volume. If you are in your mid 30’s or above age wise, and you are at a normal weight, you are probably noticing that your face looks a bit thinner each year. A full face is associated with youth. Look at the Victoria Secret supermodels that are plastered everywhere, they are all about 6’0″ tall and 120 lbs but they all have these beautiful round, full faces. That’s because they are all in their teens and 20’s.

So, we use filler to help restore the volume to your face to help you look younger. Now, today’s fillers are an evolution from the Collagen injections of days gone by. The problem with collagen was that some people were allergic to it so you had to skin test them, then wait several days or weeks, then inject, but you had to over inject them because some was going to go away almost immediately so you never really knew what your result would be, and in the end the stuff went away in 3 months or so. And it was expensive. Bad combo.

Today’s most commonly used fillers are made of Hyaluronic Acid (HA). The two most common trade names for these fillers are Juvederm® and Restylane® which you can find in almost any plastic surgeons offices. These are FDA approved products to help fill deeper facial lines and restore facial volume. HA is what is known as a GAG, a gylcosaminoglycan and is already found throughout the body in your connective tissues. So it is already a part of your person and very safe to use. The companies that produce these products all of varying claims of their longevity but what we see is that most people seem to get about 15 to 18 months out of these fillers. The HA fillers are reversible as well so if the patient does not like the result they produce the product can be dissolved. We love them and their popularity amongst our patients and nationally increases every year.

There are more sophiticated fillers like Radiesse and Scuptra. These last much longer, are irreversible and tend to be more expensive. These products are typically used for patients who have had the HA products a couple of times, know they like the results, and want a longer lasting product.

If you have filler questions contact us and schedule a consultation via e mail at lyzah@corbettcosmeticsurgery.com or 502.721.0330.

Lee Corbett, MD

Medical Director Corbett Cosmetic Aesthetic Surgery and MediSpa.

The 3 P’s of Medi-Spa safety

The idea and a lot of the content of this blog comes directly from the ASPS website blog but it is really informative and so I thought I would copy it and add some additional thoughts. MediSpa treatments are a group of minimally invasive things that usually involve an injection. What we are talking about here are things like Dysport, Botox, Juvederm, Restylane, Perlane, Sculptra, Radiesse, chemical peels and lighter laser/IPL treatments. So what are the 3 P’s? Product, Place, and Practitioner.

Product: Know what product your MediSpa is using. If you haven’t heard of a particular product or heard of it being used in the manner being proposed ask some questions. A great example of this is the Botox and Dysport debate. Botox is used to smooth wrinkles around the eyes and forehead. It is the market leader and everyone knows it by name. Well, Dysport is effectively the same product. But, it is produced by a British company and doesn’t have the same name recognition. So here is an example of something you might not have heard of that is perfectly acceptable. The other end of the spectrum would be something like liquid silicone injections. These are bad. These are the plastic surgery horror stories that you can google. Research your products! Know what is being injected. If it isn’t FDA approved to be injected say “NO!”.

Place: I’ll be the first to admit I have injected close friends with Botox and Dysport in my kitchen. Very close friends. But if you are considering injectables, be it toxins or fillers, be safe with your choice. These are medical procedures. They need to be done in the proper environment. Injectables in hair and nail salons just isn’t a great idea. Honestly the chances of immediate problems with an injection is remote, but if, just if, something unexpected occurs, you want to be in the proper venue. Finally, let me comment on the “Botox Parties”. I know plastic surgeons and derms do these but I disagree. Injecting a group of women in someone’s home when there is alcohol involved just isn’t a great idea.

Practitioner: Who are you letting put that needle in your face?? Are they trained? Who oversees them? You need to know this. In a lot of offices the Plastic Surgeon does all of his own injections. That’s ok. A lot have a nurse or a nurse practitioner do their injections. For instance in my office, I do some toxin injections, but my RN, Lyzah, does most of them. But, before she injected anyone, she was trained by me and then 3 company approved trainers for the products. Then she injected me and all of my staff. Then she injected patients with me literally looking over her shoulder. Now she has injected 1000’s of patients and I have yet to see anyone with a problem. So a properly trained non MD injector is perfectly acceptable. But if you encounter an Aesthetician or LPN or Medical Assistant injector, I would be wary.

Lee E Corbett, MD

Board Certified Plastic Surgeon