Dysport is the brand name to another neurotoxin that is used to treat the wrinkles in the upper part of the face, such as glabellar lines, the horizontal forehead creases and the crow’s feet. It is somewhat different from Botox, in that it spreads more. We use this property to our advantage by using it in areas where we would like more diffusion, such as in the crow’s feet.

I treat flat and descended cheeks with either fillers or fat transfer. I do not use cheek implants because of the high complication rate. The fillers and or fat works so well and always have a natural appearance.

Injectables, such as botox and fillers are large part of an aesthetic practice nowadays. I believe that they can be used to treat the early signs of aging as well as some areas that are not treated with surgery. However, they are a compliment to surgery and do not replace it. For example, injectables do not treat the neck and jowls, which can only be improved with surgery.

Revision rhinoplasty can be performed in an open or closed approach. The approach taken depends on your surgeon’s experience with either approach. There is not a significant amount of scarring associated with the open approach as compared with the closed. The only difference is the small incision used with the open and some additional swelling.

An eyelid lift is a procedure that improves the contour of the lower eyelid area. It involves removing or rearranging the fat in the lower eyelid and then tightening the muscle and removing a small amount of skin. Malar bags are usually areas in the cheeks, not the eyelids, that retain fluid. This may be hereditary or caused by a diet high in salt that causes the body to retain fluid. These bags can be quite challenging to treat. Steroid injections can sometimes help the bags as well as a variety of other non-surgical options.

I believe there are two basic types of fillers on the market right now. The two groups are the hyaluronic acid fillers such as Restylane, Perlane, and Juvederm. The second class is the calcium hydroxyapetite, or Radiesse. I consider this last one a volumizer more than an actual dermal filler. I use this filler to add volume, much like I use fat in the operating room. My favorite area to use it is in the cheeks, where it adds volume and gives a nice cheek lift. The hyaluronic acid dermal fillers are great for the nasolabial folds, marionette lines and for the tear trough area just between the lower eyelid and the cheek.