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A TUMMY TUCK CREATES A FLATTER, FIRMER ABDOMEN

Abdominoplasty Dubai | 20 July 2020

After pregnancy or weight loss, excess skin and fat can distort the appearance of the abdomen. In particular, many women find that after their second child or after bearing twins, their muscles and skin do not return to their original appearance secondary to repeated stretch of the abdomen. The abdominoplasty, or “tummy tuck” procedure, creates a flatter, firmer abdomen by removing excess fat and skin, and tightening the abdominal muscles. You are a good candidate for a tummy tuck if you are at a stable weight and are physically healthy, you have realistic expectations, and you do not smoke.

ANATOMY OF THE ABDOMEN

The abdominal wall consists of skin, fat, and muscle. The rectus abdominis muscles, which form the “six pack” of muscles on the abdomen, are covered by a firm sheath called the rectus fascia. This fascial layer frequently weakens and stretches out with pregnancy and weight gain. As a result, once a patient loses weight or has her children, she may be left with laxity of the abdominal wall. During surgery, the fascial layer over the rectus abdominis muscles is tightened, and the excess skin and fat are removed.

SURGERY STEPS

The abdominoplasty procedure is performed with a horizontal incision in the lower abdomen within the bikini line. In patients who have undergone a prior C-section, the incision can be made in the same location and extended to the sides. The rectus abdominis muscles of the abdomen are tightened, and the excess skin and fat are trimmed and redraped. Most abdominoplasty surgeries require repositioning of the umbilicus, or navel through a second incision. In the “mini” abdominoplasty procedure, lower abdominal muscle tightening with fat and skin removal are performed through a limited horizontal bikini incision only, without repositioning of the navel. The resulting scar is usually low on the abdomen, and therefore can be concealed within most bathing suits and clothing. Small drain tubes are placed with both techniques.

ADDITIONAL PROCEDURES

Liposuction is sometimes performed in conjunction with tummy tuck surgery to contour the flanks. Some patients wish to undergo simultaneous breast surgery to lift, add volume, or both. The combination of tummy tuck surgery and breast augmentation or lift surgery is commonly referred to as a “mommy makeover” procedure.

Additional procedures incur additional operating time, anesthesia, and surgical risks.

SURGERY AND ANESTHESIA

The surgery lasts 2 – 2.5 hours, and is performed under general anesthesia. Many patients worry about the risk of general anesthesia, but it is very safe and it assures that you will be completely comfortable during surgery. Prior to surgery you will be required to obtain medical photographs, routine bloodwork, and in some cases preoperative clearance. The evening prior to surgery, you should not eat or drink anything after midnight. This ensures that you will have an empty stomach prior to surgery, which is very important for your anesthesiologist to care for you safely. You will need to have a responsible adult available to escort you home after surgery.

RECOVERY

Following surgery, you will awaken in the recovery area. Once you are fully alert, you will be transported to the stepdown area where you will be given something to drink and the to eat. You will have two drains and a surgical garment placed at the conclusion of the procedure. The nurses in the recovery area will demonstrate how to empty and record the output from your drains. A responsible adult will need to be available to escort you home.

Patients are seen in the office 3 or 4 days following surgery. At that time your drains will be removed and you will be replaced into your surgical garment. Most sutures placed will dissolve on their own. The surgical garment should be worn for the following  4 weeks

Walking is permitted the day after surgery, but strenuous activity and heavy lifting are limited until four weeks following surgery. Most patients do not complain of severe pain following this surgery, but note that the abdomen feels “tight”, as if they have performed many sit-ups. Pain medication is prescribed for any discomfort. Swelling will be present for the initial 2-3 months after surgery, and the final results are typically seen 3-6 months after surgery. The scar will continue to fade and soften for up to one year following surgery, although it will never completely disappear.

WHAT A TUMMY TUCK CANNOT DO

A tummy tuck is not a substitute for weight loss or exercise. If you have ongoing weight loss, or are planning to become pregnant, you should delay your surgery. A tummy tuck cannot correct stretch marks, but it will remove the skin beneath the umbilicus. Stretch marks above this level some- times appear lighter after surgery, but they will not disappear.

UNDERSTANDING THE DIFFERENT TYPES OF DERMAL FILLERS

Fillers in Dubai | 18 July 2020

Injectable dermal fillers can give you a more youthful look for a fraction of what a traditional facelift costs. Most will fill hollows, lines, and wrinkles in less than 30 minutes with results that can last from 6 months to more than a year.

Injectable dermal fillers, unlike Botox injections that relax the muscle under a wrinkle, fill the line, crease, or area with one of several different substances. As a result, trouble spots nearly disappear.

Dermal fillers can also be used as “volumizers,” plumping and lifting cheeks, chins, jawlines, and temples; filling out thin lips, and plumping sagging hands.

The treatment is fast and easy. But all wrinkle fillers have a downside, including the risk of allergic reaction and the formation of tiny bumps under the skin. In some cases, those bumps may be permanent. And sometimes, a bluish skin discoloration known as the Tyndall effect happens. The color change can last for several months, but there are treatments available. In very rare cases, skin cells may die if the wrinkle fillers are not used properly. There have also been a few reported cases of blindness and nerve paralysis. Typically, the wrinkle fillers that last longer are the ones more likely to cause side effects.

Not every dermal filler is right for every type of correction. The least risks and best results come from using the right one correctly. That’s why you should only have fillers injected by a board-certified dermatologist or plastic surgeon with ongoing, special training.

Here is a breakdown of available dermal fillers. It includes their basic ingredients, how they work, their pros and cons, and the best areas for treatment. I can help you choose the right one for you.

HYALURONIC ACID 

The most popular category of dermal fillers is hyaluronic acid. Each type works in a slightly different way with varying results.

Side effects are rare but can include redness, swelling, and bruising at the injection site. The filler may also show up under the skin as tiny bumps. This is a problem that often improves over time.

How long the results last varies from several months to over a year or two. Some research shows that repeated injections may help stimulate the body’s own natural production of collagen. That will help reduce the number of lines and wrinkles. There is also some evidence that less filler is needed over time to achieve the same look.

Hyaluronic acid fillers include:

Juvederm Voluma 

Juvederm Volift

Juvederm Volbella 

Neauvia intense

Neauvia stimulate

Neauvia rheology

Restylane kiss

Restylane-Lift

Restylane Defyne

Teosyal redensity 1 and 2

Teosyal RHA 3

SYNTHETIC FILLERS

This smaller category of wrinkle fillers includes lab-made substances that are not related to anything found naturally in the skin.

All the fillers in this group have similar side effects, such as redness, swelling, or bruising at the site of the injection. Other side effects include nodules or bumps under the skin that can be seen and felt and that, in rare instances, may require surgery to remove.

The benefits include a longer-lasting effect. And at least one filler offers semi-permanent filling of lines and creases. Remember, products with longer-lasting effects are more likely to cause side effects. And when not used correctly, synthetic fillers may cause disfigurement.

Synthetic wrinkle fillers include:

Ellanse

Radiesse

Sculptra

It is important to underline that permanent fillers such as liquid silicone are dangerous and may cause severe disfigurement on the patient. Such fillers are responsible for a beautiful result in the immediate period, followed by migration, infection, displacement and other severe problems over the months/years. It is so recommended not to use them at all to avoid all this kind of problems.

COLLAGEN FILLERS

Scientists made the first fillers from a purified form of collagen extracted mostly from cows. Although it worked well and offered a natural-looking fill, the results didn’t last long. Most collagen injections began to break down as early as 1 month after treatment. Because these wrinkle fillers were made from an animal source, they also had a higher rate of allergic reaction and required allergy testing beforehand.

New ways of processing the collagen have helped lower the risks. Plus, new forms of synthetic collagens are making these injections safer and more useful to a wider range of people. Although the results don’t last as long as other fillers, many believe the results are more natural looking.

Side effects of collagen injections include some risk of allergic reaction (mostly for those still using cow sources), as well as bruising and redness at the site of the injection.

Collagen injections include:

Cosmoderm

Evolence

Fibrel

Zyderm

Zyplast

AUTOLOGOUS FILLERS

Fat is the most commonly used substance in this category. Your own fat is surgically removed from your thighs, buttocks, or stomach, treated, then injected. You will need to have two procedures (one to remove the fat and one to inject it). Both procedures can be done in one visit. Additional fat purification steps done in the lab can be costly and time-consuming. Results can be semi-permanent, although you may need a series of injections done over time.

Risks are similar to other wrinkle fillers, including bruising, redness, and swelling at the site of the injection. Because the fillers come from your body, these injections do not require FDA approval.

MINIMIZING RISKS AND INCREASING GOOD OUTCOMES FOR ALL FILLERS

Dermal fillers are among the safest cosmetic procedures in use today. But there are things you can do to help ensure your treatment is safe:

Don’t let price be your guide. If you are offered a filler treatment that costs far less than the standard treatment, it’s likely some compromises are being made, either in the skill of the provider or the quality of the product. Never risk making a bargain with your face.

All fillers should be done in a medical setting with sterile instruments. Treatments done in homes, hotels, spas, or resorts are not being done in medical environments, regardless of who is doing them.

Do not get injectable fillers from sources outside a doctor’s office. Know what you are being injected with, and ask your doctor if an FDA-approved filler is being used and if it was purchased directly from the maker. There have been reports of everything from industrial-grade silicone to baby oil being used. If a provider won’t give you this information, don’t let them do the procedure.

Use sunscreen daily to help preserve the filler and help protect against post-inflammatory pigment changes due to the needle sticks from injections.

DERMAL FILLERS FOR FACIAL REJUVENATION

Fillers in Dubai | 16 July 2020

Although no one likes the thought of aging, we can be thankful that we are living in this modern age when there are more facial cosmetic procedures than ever before to aid in the battle against time. Injectable fillers are not only effective, they are a completely safe method of rejuvenating the face.

Even in the past 10 years, there have been advancements in the science of fillers, and I can offer several different approved brands. The most popular are Juvéderm, Restylane, Radiesse, Teosyal and Neauvia.  The area of the face that requires filling determines the type of filler that the doctor will choose. Some fillers have a thicker consistency than others and are more suited to areas where more substance is needed to achieve the desired lift. It is possible to fill nasolabial folds (lines between the nose and mouth), cheekbones, noses, chins, tear troughs, jowls, and lips.

CONTOURING AND REFINING FEATURES

When injected by an experienced professional, fillers also have the ability to contour and refine features. Lips can be augmented to reduce the lines that appear with aging, and humpy noses can be starightened so that they balance nicely with other facial features. A flat chin can be injected with filler to provide a symmetrical profile. Cheek bones can be injected to provide a natural-looking lift to the face. Although amazing results can be achieved with injectable fillers, it is the artist in control of the needle who determines the final outcome. It takes artistry, not just a licence, to sculpt the face in perfect harmony and proportions.

Not only can fillers be injected in a short period of time, but there is also little discomfort for the patient. Local anaesthetic can be administered prior to the injections, and some brands even have the anaesthetic combined with the filler. Slight swelling or redness at the injection site may be experienced, but this is minimal, eliminating the need to take a few days off of work to heal. Another major benefit of injectable fillers is that they are affordable. Great results can be accomplished without breaking your pocket book.

THINGS TO KNOW IF YOU’RE CONSIDERING DERMAL FILLERS

Whether you are considering getting dermal fillers to smooth out wrinkles or enhance facial contours, a quick look at some criteria and facts will help you know you have come to the right place for your treatment.

Dermal fillers should be injected only by an experienced and qualified medical doctor. This procedure requires qualifications, experience, and an artistic edge, because 90% of the success of cosmetic procedures depends on who is doing them. For example, a bad haircut would indicate the level of experience of the stylist, not the scissors that were used. This is why it is extremely important to inquire about the credentials of your practitioner and ask to see before and after pictures. Getting a consultation first is advisable, as you would get a chance to see my facility and raise your questions or concerns with me.

YOUR EXPECTATIONS

Bringing a picture of your younger self to your appointment is helpful. However, bringing a picture of your favorite celebrity is not conducive. While you may see one aspect or feature of your face, it is important to know that a face has to be analysed in whole and not in part. The aim of the injectable procedure is to look naturally enhanced. It is also important to understand that each face has its own asymmetry. A good doctor can help bring more symmetry while keeping the overall aesthetics of the face visually pleasing. So make the most of your consultation by being open to recommendations. Your doctor sees in three dimensions, and you would benefit from exploring all your options.

THE ACTUAL PRODUCT

There are many types of dermal fillers on the market. But the most common of them are hyaluronic acid (HA) products. They have proven to produce natural and lasting results while maintaining fluidity to move with facial expressions. This line of dermal fillers also incorporates antioxidants, minerals, and vitamins to deliver further treatment benefits while filling and contouring the face.

HOW LONG THE RESULTS WILL LAST

Hyaluronic acid in dermal fillers also naturally occurs in the body and therefore gets metabolized eventually. Depending on the dermal filler chosen and whether or not this is the first time you are having a filler injected, you can expect results to last anywhere from 6 to 12 months. If for some reason you are not satisfied with the results, which is very rare, HA fillers are also dissolvable at your request by injecting an enzyme called hyaluronidase.

WHAT TO DO BEFORE AND AFTER THE INJECTION

It is always best to schedule your injectable appointments a couple of days to a week prior to any major event. With dermal filler injections, you will also need to take bruising and swelling into account. You can reduce this likelihood by stopping any supplements that can act like blood thinners such as fish oil and also some pain killers such as Aspirin, Aleve, Advil, etc., 2 weeks prior to your appointment.

After your dermal fillers treatment, follow the post-care instructions given, which include applying cold compresses, avoiding extremely cold or hot drinks, sun exposure, extreme temperatures, excess facial mimicry, and vigorous exercises. Being gentle is key.

BREAST AUGMENTATION DUBAI: PREOPERATIVE SIZING

Breast Augmentation Dubai | 11 July 2020

There are multiple factors that go into determining the best implant size for you. Breast measurements, desired size, characteristics of your breast, tissue and chest wall are all critical in making the right selection.

Breast implants are measured in cubic centimetres. That’s why you’ll typically see CC when labeling size, like 350CC. Breast implants come in a whole range of sizes, from about 80CC up to 800CC. Obviously, the higher the number, the bigger the breast implant size. The width of the base also varies, fom 7.4cm to 17.2cm.

Don’t measure your breast size by your bra

Bra cup size is not an accurate way to measure breast size. It is imprecise, because bra sizing standards vary from manufacturer to manufacturer and even country to country. Despite being labeled the same cup size, the actual volume may be different. That’s why it’s best if you bring in the exact bra you want to wear after your surgery to your sizing session.

How I help determine a proportionate implant size

From a medical standpoint, it’s important that I also consider your specific body measurements when deciding on what size is right for you. An overly large implant can cause complications, both right after surgery and a few years down the road. Such complications include separation of incision lines and excessive sagging. However, I also understand that an overly small implant won’t improve your body contour sufficiently.

Measurements, like your shoulder width, height and ribcage width is used to determine a range of implant sizes that would achieve proportionate improvement as well as reduce your risk of complications.

Factors that you should consider when choosing breast implant measurements

There are multiple factors that come into play when selecting the right implant size. If you don’t carefully pre-plan, you could run into situations in life that would adversely affect you and your new implants. You should take into consideration the following when selecting your implant size:

Fitness and exercise

Do you like to exercise regularly? If so, perhaps it’s best to stay conscious of the fact that breasts over a certain size can make some physical activities more difficult or cumbersome, such as running and tennis.

Your personality

Are you the type of person that likes to attract attention, or are you more quiet and reserved? The larger the implants, the more attention you could attract. You may want to opt for a slight increase in size, just enough to balance out your body contour for a more natural look.

Be true to yourself

You shouldn’t base your decision on breast size based on an actress that you saw on the internet. They are not you. You should select a size that accurately reflects your own personality and lifestyle. Don’t base your chosen size on how your girlfriend looks, either. Her body is different and the breast size she has may not look very flattering on your body.

Communicate effectively with your doctor

A breast implant consultation is a two-way street. You need to express your expectations and it’s my job to understand them so I can help you achieve them. If you feel that your concerns are not being addressed, don’t be afraid to ask for more clarification or explain your situation further. I’m here for you!

Know what you want

You should not agree to undergo the surgery until you’re confident that you’ll like your new look and size. If you have any doubts prior to your surgery, talk to me about them! We can also schedule another in-clinic implant sizer session.

As you can see, there are many factors that you need to take into consideration when selecting your implant size. You shouldn’t choose a size because it looks good on a friend or celebrity. You should select a size that is right for you. The process is personal and while you should take your doctors suggestions into consideration, you have the final say in the size you select.

Answer your surgery doubts

Unsure of the difference between 300cc and 400cc? Want a natural result? Wondering how you will look after surgery? Want to look like a specific celebrity? Discover your new you  with Crisalix – the leading VR 4D & 3D imaging solution among plastic surgeons around the world. Crisalix carries out ongoing post-consultation and surgery studies with patients to measure their level of satisfaction.

BENEFITS OF FACELIFT SURGERY

Plastic Surgery Dubai | 8 July 2020

A face-lift (rhytidectomy) is a cosmetic surgical procedure to create a younger appearance in your face. The procedure can reduce the sagging or folds of skin on the cheeks and jawline and other changes in the shape of your face that occur with age. During a face-lift, a flap of skin on each side of the face is pulled back, and tissues below the skin are surgically altered to return the contour of the face to a more youthful shape. Before the flap is sutured closed, excess skin is removed. A neck lift (platysmaplasty) is often done as part of a face-lift to reduce fat deposits and sagging skin on the neck. A face-lift won’t decrease fine creases or wrinkles in your skin or damage from sun exposure. Other cosmetic procedures can address the appearance or quality of the skin itself.

As you get older, the appearance and shape of your face is altered because of normal age-related changes. Your skin becomes less elastic and looser, and fat deposits decrease in some areas of your face and increase in others. Age-related changes in your face that may be reduced with a face-lift include the following:

Sagging appearance of your cheeks

Excess skin at your lower jawline (jowls)

Deepening of the fold of skin from the side of your nose to the corner 

   of your mouth

Sagging skin and excess fat in the neck (if the procedure includes a 

   neck lift)

A face-lift isn’t a treatment for superficial wrinkles, sun damage, creases around the nose and upper lip, or irregularities in skin color.

WHO IS A CANDIDATE?

Men and women with jowl formation (the lower cheeks and jaw line 

   are saggy).

Men and women with a poorly defined jaw line.

Men and women with wrinkled saggy and fatty neck.

INTENDED RESULTS

A sharper and better defined jaw line.

Improved neck and chin angle.

Less tired look with more youthful appearance.

This does not treat the lines around the mouth and will not improve skin surface defects and dis-coloration.

HOW YOU PREPARE

Initially, you’ll talk to Dr. Vigo about a face-lift. The visit will likely include:

MEDICAL HISTORY AND EXAM

Prepare to answer questions about past and current medical conditions, previous surgeries, previous plastic surgeries, complications from previous surgeries, history of smoking etc. Dr. Vigo will do a physical exam, may request recent records from your doctor or order a consultation with a specialist if there are any concerns about your ability to undergo surgery.

MEDICATION REVIEW 

Provide the name and dosages of all medications you regularly take, including prescription drugs, over-the-counter drugs, herbal medications, vitamins and other dietary supplements.

FACIAL EXAM

Dr. Vigo will take photos of your face from different angles and close-up photos of some features. He will also examine your bone structure, shape of your face, fat distribution and quality of your skin to determine your best options for face-lift surgery.

EXPECTATIONS 

Dr. Vigo will ask questions about your expectations for the outcomes of a face-lift. He or she will help you understand how a face-lift will likely change your appearance and what a face-lift doesn’t address, such as fine wrinkles or naturally occurring asymmetry in your face.

BEFORE A FACE-LIFT

Follow medication directions. You’ll receive instructions about what medications to stop taking and when to stop. For example, you’ll likely be asked to discontinue any blood-thinning medication or supplement at least two weeks before surgery. Talk to your doctor about what medications are safe to take or whether the dosage should be adjusted. Wash your face and hair. You’ll likely be asked to wash your hair and face with a germicidal soap the morning of the surgery. Avoid eating. You’ll be asked to avoid eating anything after midnight the night before your face-lift. You will be able to drink water and take medications that have been approved by Dr. Vigo. Arrange for help during recovery. If your face-lift is done as an outpatient procedure, make plans for someone to drive you home after surgery and stay with you the first night after surgery.

BEFORE THE PROCEDURE

Sometimes the procedure is done with sedation and local anesthesia, which numbs only part of your body. In other cases, general anesthesia — which renders you unconscious — is recommended.

DURING THE PROCEDURE

Face Lifts are usually performed in an accredited facility, day care 

  centre or in the hospital.

They may be performed under local anesthesia

  with or without oral sedation, conscious sedation, or general anesthesia.

The surgeon usually makes incisions around the ear. The approach and 

  position of the scar should be discussed with the surgeon.

Sutures are used for closure followed by placement of an elastic 

  dressing around the face and neck. Often a drain is needed to avoid 

  complication of fluid collection.

In general, a face-lift involves elevating the skin and tightening the underlying tissues and muscles. Fat in the face and neck may be sculpted, removed or redistributed. Facial skin is then re-draped over the newly repositioned contours of the face, excess skin is removed, and the wound is stitched or taped closed. The incisions for the procedure depend on the techniques that will be used and the patient’s preferences. Options include:

A traditional face-lift incision starts at your temples in the hairline, 

  continues down and around the front of your ears and ends behind 

  your ears in your lower scalp. An incision might be made under your 

  chin to improve the appearance of your neck.

A limited incision is a shorter incision that begins in your hairline just 

  above your ear, wraps around the front of your ear, but does not extend 

  all the way into the lower scalp.

Neck lift incision starts in front of your earlobe and continues around 

  your ear into your lower scalp. A small incision also is made under your 

  chin.

A face-lift generally takes two to four hours but might take longer if 

  other cosmetic procedures are done at the same time.

AFTER THE PROCEDURE

After a face-lift, you may experience:

Mild to moderate pain

Drainage from the incisions

Swelling

Bruising

Numbness

Contact your doctor immediately if you have:

Severe pain on one side of your face or neck within 24 hours of surgery

Shortness of breath

Chest pain

Irregular heartbeats

Your incisions will likely be covered with bandages that provide gentle pressure to minimize swelling and bruising. A small tube might be placed under the skin behind one or both of your ears to drain any excess blood or fluid. In the first few days after surgery:

Rest with your head elevated

Take pain medication as recommended by your doctor

Apply cool packs to the face to ease pain and reduce swelling

Follow-up appointments

 RECUPERATION AND HEALING

A compression garment may be worn around the lower face and neck 

  for approximately one week.

Bruising and swelling are normal and may take several weeks to resolve.

Stiffness in the neck and some soreness with swallowing and eating is 

  common.

Sutures are removed within two weeks.

Drains, if used are usually removed 1-3 days after the procedure.

Make-up can be applied over the skin immediately but not over the 

  incisions for 2-3 weeks.  

THE BENEFITS OF BODY LIFT SURGERY

Plastic Surgery Dubai | 5 July 2020

A body lift is a surgical procedure to remove loose skin and excess tissue after significant weight loss. The procedure offers numerous benefits to those that have lost weight quickly due to bariatric surgery or their own dieting efforts. If you have reached the target number on the scale but do not see the results you were hoping for when you look in the mirror, body contouring surgery may be the right choice for you. 

During your consultation with Dr. Vigo, he will perform a physical evaluation and review your goals for body lift treatment. Together, you will select the most beneficial combination of procedures to provide you with the most dramatic results that will highlight and enhance your features. A full body lift may include any of the following procedures in the upper, mid, and lower sections of your body:

Abdominoplasty, or tummy tuck, removes excess skin and fat from the abdomen for a tighter and more toned mid-section

Thigh and leg lift removes skin and fat deposits from the thighs and legs for more defined thighs and calves

Buttock lift can trim skin and fat to lift and reshape the buttocks

Arm lift, or brachioplasty, can remove excess, hanging skin from the upper arms

Breast lift removes excess skin and tissue to situate the breasts in a higher position

Each of these procedures will remove excess tissue to tighten and tone your skin for improved contours in that specific area. Dr. Vigo emphasizes clear cosmetic goals for all of his patients. 

FULL BODY LIFT BENEFITS

While each of these procedures on their own can produce quality results, when two or more are combined, your results can be even more dramatic. Benefits of a full body lift may include:

Removal of excess, sagging skin for a slimmer figure and to eliminate 

  health issues such as rashes or skin infections

Firm, toned, and smoother skin that accentuates your weight loss 

  success

Elimination of folds of skin, making personal care easier

Exercise and other physical activities may be easier and more 

  comfortable

Wider variety of clothing options

Rejuvenated and more youthful appearance

Improved confidence and self-image

During your consultation, Dr. Vigo will outline the specific benefits you may see from a full body lift based on the personalized combination of procedures you choose.

Customized to Your Needs

Body lifts can be completely customized to the unique needs of each patient. Dr. Vigo is experienced in a wide range of body lift procedures and will help you determine the right procedures for you. In some cases, your lift procedures will be performed simultaneously to provide you with dramatic results with just one time under anesthesia and one recovery period. Other patients might require two or more procedures to reach their desired outcome without sacrificing their safety.

Creates a Smoother Body Contour

When you started on your weight loss efforts, you probably had an image in your mind of how your final result would look. That image probably did not include extensive folds of loose skin hanging over those newly sculpted areas, marring your overall profile. By removing skin folds, you can streamline your body contour to get much closer to the image you had in your mind before you began your journey. The cosmetic improvement can do much to increase your self-esteem and your self-confidence, as well as your satisfaction with your weight loss success.

Eliminates Skin Irritation, Infection

When you have loose skin rubbing together, you also have an increased risk for skin irritation and even infections. This problem can become quite painful, impacting your ability to wear some types of clothing and participate in some activities. You may require multiple treatments to manage ongoing skin conditions, which can be inconvenient and time consuming in addition to physically painful. When we eliminate the loose skin, we also effectively eliminate the skin issues.

Allows for Smaller Clothing Sizes

Before you began your weight loss, you were probably looking forward to fitting into smaller sizes of clothing. Unfortunately, loose skin left behind can continue to hinder your ability to wear the clothing you had been waiting for. In addition, the extra skin can make clothing uncomfortable, keeping you from donning some of your favorite pieces. Body lift procedures can smooth your body contours to make those smaller clothing sizes more comfortable.

Understanding the Procedure

During a body lift, Dr. Vigo may take one of several approaches, depending on the level of correction needed. The location and amount of excess skin to be removed is another factor, as is any personal preference you may have about your final appearance.

Typically, a body lift begins with a circumferential incision that extends around the lower body. This gives Dr. Vigo access to the treatment areas, including the belly, waist, hips, thighs and buttocks. Next, excess skin and fat are removed, and the remaining skin is repositioned and re-draped. Liposuction may also be incorporated to help remove fatty deposits in the treatment area. Finally, the incisions are closed and the recovery process begins.

Recovery and Results

Most men and women experience discomfort following their body lift, including soreness at the incision site and initial swelling. As these dissipate, more well-defined lower body contours are seen. Most patients can return to work in a week or two. However, more active pursuits should wait until you feel more comfortable.

A body lift helps you feel better about your body following major weight loss or other physical changes that left loose skin behind. Although it’s important to maintain realistic expectations, you can expect to see a permanent improvement in your lower body contours as long as you maintain a healthy and active lifestyle.

Body lift, or body plastic surgery, helps reduce saggy, loose appearance and irregularities on the surface of the skin due to poor elasticity, or laxity in the central area of the body. Loss of elasticity may occur as a result of significant weight loss, aging, sun damage, and genetics, among various other factors. This is a common surgery for patients who have lost weight after weight loss surgery (bariatric procedures).

What Body Lifts Can Treat

A body lift can help your body appear smoother, more toned, and shapelier overall. Body lifts can treat the appearance of excess skin, fat, and cellulite by removing these tissues from various parts of the body. If you are bothered by the appearance of loose, sagging skin or fat tissue in multiple parts of your body, you may benefit from body lift surgery. After weight loss many patients believe they’re able to achieve greater overall satisfaction and quality of life when they look and feel better.

To achieve the best results, it’s recommended that you maintain a normal body weight for at least a year – especially if you’ve just recently achieved significant weight loss – before moving forward to body lift procedures. It may also be best to postpone abdominal body lifts if you’re planning for further weight loss or future pregnancies. The best way to determine whether you’re a good candidate for body lift surgery is through a one-on-one plastic surgery consultation.

Preparing for Body Lift Surgery

The initial step in any surgical procedure is consultation. Before your body lift surgery, be prepared to discuss your expectations with Dr. Vigo.

 

WHAT IS BREAST AUGMENTATION SURGERY?

Breast Augmentation Dubai | 1 July 2020

Breast enlargement surgery, also known as breast augmentation or breast enhancement, is one of the most regularly performed procedures and involves the insertion of implants under the breast tissue to increase the size or change the shape of the breasts. Many women choose to have breast augmentation surgery to boost body confidence and to feel comfortable with the size and shape of their breasts.

WHAT IS BREAST AUGMENTATION SURGERY?

Breast enlargement surgery is an operation to enlarge the breasts, usually using an implant filled with silicone or with physiological saline (a solution containing salt at the same concentration as in the body).Sometimes, the breasts can be enlarged with fat from another part of the body. Patients are usually pleased with the results of breast augmentation, but first it is important to understand what is and isn’t possible, and what care might be needed in the future.

WHY HAVE BREAST AUGMENTATION SURGERY?

People have this surgery to make their breasts larger and improve their shape. Some women have smaller breasts than they would like. Also, breasts can droop with age or after pregnancy, breastfeeding and weight loss. Breast enlargement can improve both the shape and the droop to some degree. Some women have one breast much bigger than the other. Breast enlargement can balance breasts of different sizes.

WHAT WILL HAPPEN BEFORE MY OPERATION?

You will meet your surgeon to talk about why you want surgery and what you want. The surgeon will make a note of any illnesses you have or have had in the past. They will also make a record of any medication you are on, including herbal remedies and medicines that are not prescribed by your doctor.

Your surgeon will examine your breasts, and may take some photographs for your medical records. They will ask you if you want to have someone with you, and ask you to sign a consent form for taking, storing and using the photographs. The surgeon may measure your height and weight to make sure that it is safe to do an operation. If you are overweight, or planning to become pregnant, your surgeon may suggest delaying your operation.

HOW IS THE PROCEDURE PERFORMED?

Implants are placed either behind the breast or behind the muscle the breast sits on. Putting implants behind the breast is the simplest option. Putting implants under the muscle gives more padding in very slim women. Your surgeon will discuss which is best for you. Implants are usually inserted through a cut in the crease under the breast (the inframammary fold). They can also be inserted through a cut in the armpit or around the areola. Sometimes, a drain (a tube attached to a bottle or bag) is left in to drain away any fluid or blood. This is removed after a day or two on the ward.

ABOUT THE IMPLANTS

The outer layer of breast implants is made of silicone or, in some cases, polyurethane. Inside this there is either silicone gel (most common) or saline. Silicone implants usually feel more natural than saline ones, and can have different shapes. Saline-filled implants usually feel less natural, have a greater risk of rippling, and can deflate. Breast implants usually last about 10 years, sometimes less, sometimes more.

IMPLANT SIZE

The size of implants is given in millilitres (ml), in cubic centimetres (cm3) or by weight (grams). When you meet your surgeon before the operation, they will look at your breasts and the size of your ribcage, and check how firm your skin is. They will discuss with you what size of implant will suit you best. Usually, large implants look less natural on slimmer women. Your surgeon will ask you if you want to have someone with you during this examination. Your surgeon cannot promise you an exact cup size, only a range. Tell your surgeon if you would like to aim for the larger or smaller end of the particular range.

IMPLANT SHAPE

Implants can be round or teardrop-shaped (anatomical). Round implants are fuller at the top of the breast. With teardrop-shaped implants, you choose the width and height separately. With both shapes, you can choose for the amount that the implant sticks out (the projection) to be more or less subtle. You and your surgeon will discuss what shape will suit you best.

DO I NEED A BREAST UPLIFT?

Mild droopiness can be improved by breast enlargement surgery. If your breasts are droopy but the right size for you, you can have a breast-uplift operation without an implant. This surgery is called a mastopexy. With this surgery, the nipple is lifted and the breast tissue and skin is tightened through cuts around the areola and under the breasts. Sometimes, both implants and lifting are needed, either at the same time or in two separate operations.

CHOOSING A SURGEON

Breast enlargement is a lifetime commitment. You must be sure that you are making the right choice, and understand the implications of the surgery. You might need more surgery in the future to keep up the results of the breast augmentation, and you should be prepared for this, personally and financially. Nobody needs an urgent breast augmentation. If you are not given time to think about it, you should look elsewhere.

HOW CAN I HELP MY OPERATION BE A SUCCESS?

Be as healthy as possible. It is important to keep your weight steady with a good diet and regular exercise. Your doctor can give you advice on this. If you smoke, stopping at least six weeks before the operation will help to reduce the risk of complications. Do not worry about removing hair near where cuts will be made, but do have a bath or shower during the 24 hours before your operation to make sure that the area is as clean as possible.

WHAT IS THE ALTERNATIVE TREATMENT?

A simple alternative to breast augmentation is to wear padded bras. The only alternative surgical technique to enlarge the breast is lipofilling. This is where fat removed by liposuction from another part of the body (such as the hips or thighs) is injected into the breast area. Because only a relatively small amount of fat can be injected at a time, and some of the fat is reabsorbed into the body, you would need several injections to get a permanent enlargement. Your own fat is the only substance that can be safely injected into the breast. Other materials have been tried, and then banned. Do not allow anyone to inject anything other than your own fat into your breasts.

WHAT ARE THE MAIN RISKS AND COMPLICATIONS OF BREAST AUGMENTATION SURGERY?

As with all operations, there are risks involved in breast augmentation surgery. Although the risks are unlikely, it is important to weigh them up against the potential benefit of the surgery. Discuss each of them with your plastic surgeon to make sure you understand the potential complications and consequences.

SCARS ASSOCIATED WITH THE SURGERY

There will be scars from the surgery. These will usually be red at first, then purple, and then fade to become paler over 12 to 18 months.   

Fillers in Dubai | 29 June 2020

Fillers are typically used to increase the volume and size of the lips. Collagen or hyaluronic acid-based filler are typical. Collagen works by plumping, while hyaluronic acid works by both plumping but also holding water within the lip for a more natural effect.

WHAT ARE LIP FILLERS?

Let’s start with what they’re not: they are not permanent. They last about three months to a year depending on how quickly your body breaks them down. The type I recommend are made of hyaluronic acid — a sugar, found naturally in the body, that adds temporary volume and definition when injected into lips.

CORRECTING BALANCE AND SHAPE

The lips can sometimes tend to be uneven with the top or bottom one thicker than they should be. To get a perfect pout the top lip should be one third and the bottom lip should be two thirds. Sometimes they are also larger on one side than the other and the lips are a little lopsided. Dermal filler can even this out

The objective in treating the upper lip is to artistically create a form that harmonizes with the patient’s unique facial features and takes into account the age and ethnic background of the patient. The goal in treating the lower lip is to create bulk and greater prominence and artistic projection of the vermilion. The physician must establish appropriate guidelines and patient expectations for augmentation relative to normal lip proportions in order to avoid a cartoon-like appearance.

It’s important to see your box of injectables opened in front of you and to be sure only your dermatologist or plastic surgeon is doing the injections. Avoid blood thinners, like aspirin and fish oil, for at least a day beforehand, which can increase bruising. If you opt for numbing cream, expect it to be placed on the lips for approximately 10 minutes. The lips absorb quickly and do not require lengthy topical anaesthesia. Then, the skin surface should be cleansed properly and then injections are performed. Your doctor should go very slowly, often pausing to show you the progress that he or she is making. There is a real balance and art to it, I find that you really need to go little by little, so you normally inject the top lip first, balance it out on the other side, then inject the bottom lip. It takes about 15 to 20 minutes. What you see is what you get, you’re not waiting for it to work, like Botox.

Some doctors will gently mould the filler with their fingers after it is injected by squeezing and patting it into place, while others aim to inject it exactly where they want it and avoid moulding, since it can increase bruising and swelling. Based on my extensive experience, there is no single stance on moulding – it’s a technique that some like, while others do it sparingly.

FILLER SUITABILITY

When selecting a suitable filler for the lips, the following factors are taken into consideration:

Longevity: it is important to advise the patient how long a product is expected to last for, and explain that this is not guaranteed in order to successfully manage their expectations

Crosslinking technology: relates to longevity and propensity to swell

Cost: patient needs to be aware of financial commitment

Company support: specific product knowledge and training/marketing is essential

Reversibility: ensures a safety net incase of vascular accident or other filler-associated complications; you should have an emergency kit including hyaluronidase on site

Strong clinical study evidence: ensures a safe, evidence-based choice

Previous patient experience of product: if a patient has had good clinical results with a certain product and is happy with it, do not use something else as they may be unhappy with the new product

LIP AUGMENTATION TECHNIQUES

There is no single technique that fits every lip, and each practitioner will have his or her own approach to treatment. Below are the factors of which typically followed when it comes to lip augmentation:

Visually assess the lip in 3D: i.e. the lateral and frontal view. This will give an idea of projection required. For an attractive lip, the upper lip should project around 2mm further than the lower lip.

Assess the smile: if the patient has a ‘gummy’ smile and the lip disappears upon smiling then consider botulinum toxin injections to soften the action of the lip elevators. I have found that for best results, it should be a deep injection, 1cm lateral to the lateral alar of the nose. If the patient has an active depressor angulioris, contributing to a downturned mouth, also consider treating this muscle with botulinum toxin to prevent a downward pull of muscle on the corners of the mouth.

Determine the amount of filler: I always agree with the patient the amount of filler that will be used. It is important to not over or underfill the lip (amount is case dependent). For example, overfilling the upper lip can create a ‘duck lip’ appearance, which is usually not regarded as aesthetically appealing. I do not use more than 1ml per visit to prevent overcorrection and reduce the risk of vascular compression.

Enhancement or restoration: I always ask if the patient is seeking enhancement or restoration – this usually depends on the patient’s age – to ensure that you understand their expectations of treatment.

Age appropriateness: ensure that the lips are ‘age appropriate’. I advise not to try to create the lips of a 25 year old on a 60-year-old patient.

In patients showing signs of ageing: treat the perioral complex and not just the lip. To do this, use filler to turn up the corners of the mouth at the oral commissure, to treat oral rhytids and to restore volume in the cutaneous lip and chin area. Botulinum toxin in the mentalis and depressor angular oris can be used to reduce hyperkinetic activity of mouth depressors.

Consider the vermillion border: consider using low viscosity filler when treating the vermillion border. This can create a very sharp and well-defined demarcation by creating maximum light reflection without distorting the delicate lip architecture.

POST-INJECTION CARE

Cool compresses and ice packs can be used to minimize swelling and bruising. Patients should be advised to avoid ASA, NSAIDs, and other medications associated with an increased risk of bleeding. If anti-HSV I medication was prescribed, it should be continued according to physician recommendation. Because HAs are hydrophilic, they attract water from the surrounding tissues and further augment the soft tissue volume beyond that expected from mere implantation. The significant swelling of the vermilion in the immediate post-operative period may be camouflaged by applying flesh-toned foundation or concealer to the entire vermilion. Lipstick can then be applied to a smaller portion of the vermilion than usual so as to not exaggerate the swelling that may be present.

 

SELECTING THE RIGHT FILLER

There are a lot of difficult decisions you have to make when it comes to getting lip injections, but fortunately, picking the right filler isn’t one of them. Hyaluronic acid, in a few different forms, is both the industry standard for temporary lip injections and the only temporary lip filler approved by the FDA. 

They’re marketed under different brand names – Restylane Silk, Belotero, Juvederm – but they’re all made from the same molecule, which is hyaluronic acid, as you may already know, naturally occurs in skin and is a top ingredient in hydrating skin-care products, since it plumps skin by capturing and holding onto water. Picking which of the formulas is best for you is really up to your doctor. Hyaluronic acid is not only the best option, but the only option for those new to the world of injections, since it will dissolve on its own and is well-tolerated, since it’s already in your body. There are irreversible fillers and implants, but those are not for beginners. 

PAIN MANAGEMENT

Lips are one of the more uncomfortable places to inject filler. We have a lot of nerves in our lips, so I can do a combination of topical numbing cream and, sometimes, injectable numbing medications, so patients are comfortable. However, many of the H.A. injectables come with lidocaine (a numbing pain reliever) built right in, so some doctors opt out of additional measures. One, or a combination of the above pain-reducing options, will normally temper the pain of the actual procedure, but you’re likely to experience pain later, since the skin is being stretched. The pain as mild to moderate and notes that it can last for a few days.

SIDE EFFECTS

Any time there is a needle crossing the skin, there is a risk. Bruising, swelling, and pain – all of which can last up to days and in rare cases, even weeks – may occur. There is also the risk of infection. Naturally, this makes it very important to check in with your doctor post-treatment, especially if you’re feeling nervous about side effects.

While hyaluronic acid is a naturally occurring substance in your body, you can still have an allergic reaction to H.A. injectables, since there are often inactive ingredients (like carrying agents) and pain-reducing ingredients (like lidocaine) in the formula. Those prone to allergies or are just plain nervous can do a patch test on their forearm a few days before the procedure to be sure they won’t have an adverse reaction.

Injecting the lips can prompt cold sores for those who are prone to them, so he normally pretreats those patients with a round of anti-viral medication, like Valtrex.

There are also less common side effects that are important to consider. More rare side effects include nodules or palpable material within the lips – basically bumps of H.A. that don’t settle or feel natural. Extremely rarely, lip filler can be introduced into a blood vessel in the lip, which can have more significant consequences if not dealt with immediately and appropriately.

WHAT TO EXPECT

One of the great things about lip injections is that the results are instantaneous, so you’ll leave the office with fairly accurate (albeit swollen) results. For the first 24 to 48 hours, the filler is malleable and your skin is prone to swelling, which means be gentle! This is noted as the time that your injections need to “settle.” No facials, yoga, or exercise is recommended, which can alter the placement of the filler and increase swelling and bruising.

Lips often swell for one to three days after treatment, but this is highly variable and some patients will experience no swelling and some will have more dramatic swelling that will take longer to subside. Bruising can last approximately one week, but can be covered with makeup or lipstick, as needed. Some doctors will offer to treat more significant bruising with a laser treatment if necessary.

While the average length of time H.A. fillers will last is about six months, it varies for everyone, from around three months to a year.  H.A. lasts different lengths, depending on where you put it and how active that body part is. I find that if the labelling says six to 12 months, [patients] normally come back every three to six months.

NON-SURGICAL NOSE RESHAPING

Aesthetic Medicine Dubai | 22 June 2020

Until recently, nose reshaping was a painful surgical procedure that requires an overnight stay in the hospital and long recovery period. Non-Surgical Nose Reshaping, also known as Non-Surgical Rhinoplasty is a safe, non-invasive procedure that uses dermal fillers to alter or reshape your nose, smoothing out any bumps and irregularities.

The non-surgical nose job became a popular treatment for different age groups because it is an excellent choice for those who don’t want to have surgery. Major advantages of Nose Reshaping Fillers are that you can return to work the next day and resume your daily routine. No more hospital stay, leave of absence or long recovery period.

Let me help you to be happy with what you see in the mirror by having a super effective, walk-in walk-out procedure, with no complications and scalpels.

The non surgical rhinoplasty or non surgical nose job is a highly advanced procedure. I will use premium hyaluronic acid nose fillers to shape your nose and balance your profile. As such this treatment is completely tailored to your individual face shape and aesthetic goals.

NON SURGICAL RHINOPLASTY WITH NOSE FILLERS

The non surgical rhinoplasty is an advanced corrective procedure. Using hyaluronic acid dermal fillers, the nose can be reshaped with just a small number of injections in a short period of time with little to no downtime involved. As such, the non surgical rhinoplasy has become extremely popular with both men and women alike. This treatment is performed using premium hyaluronic acid to reshape the nose and provide harmony to the face. 

I use nose fillers to alter the definition, projection, profile and shape of the nose. As such, non surgical rhinoplasty is best for straightening, lengthening, smoothing out bumps or dents and improving asymmetries in the nose. The key benefits of my personalised non surgical rhinoplasty include:

Safe & effective treatment using premium dermal fillers

Fully bespoke non surgical rhinoplasty nose reshaping treatment

Profile balancing by treating the chin area if needed

All treatments performed by an experienced aesthetic doctor

Premium hyaluronic acid dermal fillers

Natural looking results

Dedicated aftercare and follow-up

WHAT ARE THE BENEFITS OF THIS TREATMENT OVER TRADITIONAL RHINOPLASTY?

Aesthetic Medcine now has more and more options for performing non-surgical procedures. Being non-surgical it means less risk, less downtime, fewer side effects and yet with very similar results. The new non-surgical nose job using dermal fillers means I can do so much in minutes and with no pain. Surgical rhinoplasty, however, takes a month or longer to recover from and results are not always perfect. I was one of the first doctors a few years ago who developed the technique of the non-surgical procedure now done by doctors all over the UAE.

WHAT DOES THE NON SURGICAL RHINOPLASTY PROCEDURE INVOLVE?

All of my non surgical rhinoplasties start with a detailed consultation. This allows me to design a bespoke treatment based on your individual needs and aesthetic goals. The treatment starts with a thoroughcleansing of the skin then applying a numbing cream for your comfort. I will then inject the nose filler using either a needle. I may also inject the chin area to help balance the profile of yourself as part of the procedure.

WHO IS BEST SUITED FOR A NON SURGICAL RHINOPLASTY?

Non surgical rhinoplasty is a quick and non invasive method to shape the appearance of the nose. This treatment uses hyaluronic acid dermal fillers which are temporary and slowly broken down by your body over time. I am able to deliver excellent results using nose fillers for:

Mildly crooked nose to improve symmetry

Small nose that needs building up

Hook-shaped nose that requires straightening

Mild or moderate bump on the bridge of the nose that needs smoothing

A mild to moderate drooping of nasal tip that

Noses that would like more height, definition and a nose tip

WHEN WILL I SEE RESULTS AND HOW LONG DO THEY LAST FOR?

You will be able to see the result immediately and the full effect at 1-2 weeks. The results can last for up to 18-24 months. This is dependant on which of our hyaluronic acid dermal fillers you choose and how quickly your body breaks it down. I will help you decide which dermal filler is best for your needs.

HOW SAFE IS A NON-SURGICAL NOSE JOB?

Juvéderm and Restylane Perlane, which are usually used in this procedure, are biocompatible and biodegradable products which means that it is not harmful to the body and is broken down and removed from the body naturally. These hyaluronic acid nose fillers come in the form of a sterile gel produced in the laboratory.

FILLERS IN DUBAI: THE PERFECT LIPS FOR YOUR FACE

Fillers in Dubai | 20 June 2020

Read my lips: I’m not saying you need lip injections. But if you’d like to try them or are curious about the procedure (and it’s kind of impossible not to be, given the current state of pouty celebrities and volumising lip products), it’s important to fill up on facts before you go plumping anything.

The objective in treating the upper lip is to artistically create a form that harmonizes with the patient’s unique facial features and takes into account the age and ethnic background of the patient. The goal in treating the lower lip is to create bulk and greater prominence and artistic projection of the vermilion. The physician must establish appropriate guidelines and patient expectations for augmentation relative to normal lip proportions in order to avoid a cartoon-like appearance.

It’s important to see your box of injectables opened in front of you and to be sure only your dermatologist or plastic surgeon is doing the injections. Avoid blood thinners, like aspirin and fish oil, for at least a day beforehand, which can increase bruising. If you opt for numbing cream, expect it to be placed on the lips for approximately 10 minutes. The lips absorb quickly and do not require lengthy topical anaesthesia. Then, the skin surface should be cleansed properly and then injections are performed. Your doctor should go very slowly, often pausing to show you the progress that he or she is making. There is a real balance and art to it, I find that you really need to go little by little, so you normally inject the top lip first, balance it out on the other side, then inject the bottom lip. It takes about 15 to 20 minutes. What you see is what you get, you’re not waiting for it to work, like Botox.

Some doctors will gently mould the filler with their fingers after it is injected by squeezing and patting it into place, while others aim to inject it exactly where they want it and avoid moulding, since it can increase bruising and swelling. Based on my extensive experience, there is no single stance on moulding – it’s a technique that some like, while others do it sparingly.

FILLER SUITABILITY

When selecting a suitable filler for the lips, the following factors are taken into consideration:

Longevity: it is important to advise the patient how long a product is expected to last for, and explain that this is not guaranteed in order to successfully manage their expectations

Crosslinking technology: relates to longevity and propensity to swell

Cost: patient needs to be aware of financial commitment

Company support: specific product knowledge and training/marketing is essential

Reversibility: ensures a safety net incase of vascular accident or other filler-associated complications; you should have an emergency kit including hyaluronidase on site

Strong clinical study evidence: ensures a safe, evidence-based choice

Previous patient experience of product: if a patient has had good clinical results with a certain product and is happy with it, do not use something else as they may be unhappy with the new product

LIP AUGMENTATION TECHNIQUES

There is no single technique that fits every lip, and each practitioner will have his or her own approach to treatment. Below are the factors of which typically followed when it comes to lip augmentation:

Visually assess the lip in 3D: i.e. the lateral and frontal view. This will give an idea of projection required. For an attractive lip, the upper lip should project around 2mm further than the lower lip.

Assess the smile: if the patient has a ‘gummy’ smile and the lip disappears upon smiling then consider botulinum toxin injections to soften the action of the lip elevators. I have found that for best results, it should be a deep injection, 1cm lateral to the lateral alar of the nose. If the patient has an active depressor angulioris, contributing to a downturned mouth, also consider treating this muscle with botulinum toxin to prevent a downward pull of muscle on the corners of the mouth.

Determine the amount of filler: I always agree with the patient the amount of filler that will be used. It is important to not over or underfill the lip (amount is case dependent). For example, overfilling the upper lip can create a ‘duck lip’ appearance, which is usually not regarded as aesthetically appealing. I do not use more than 1ml per visit to prevent overcorrection and reduce the risk of vascular compression.

Enhancement or restoration: I always ask if the patient is seeking enhancement or restoration – this usually depends on the patient’s age – to ensure that you understand their expectations of treatment.

Age appropriateness: ensure that the lips are ‘age appropriate’. I advise not to try to create the lips of a 25 year old on a 60-year-old patient.

In patients showing signs of ageing: treat the perioral complex and not just the lip. To do this, use filler to turn up the corners of the mouth at the oral commissure, to treat oral rhytids and to restore volume in the cutaneous lip and chin area. Botulinum toxin in the mentalis and depressor angular oris can be used to reduce hyperkinetic activity of mouth depressors.

Consider the vermillion border: consider using low viscosity filler when treating the vermillion border. This can create a very sharp and well-defined demarcation by creating maximum light reflection without distorting the delicate lip architecture.

POST-INJECTION CARE

Cool compresses and ice packs can be used to minimize swelling and bruising. Patients should be advised to avoid ASA, NSAIDs, and other medications associated with an increased risk of bleeding. If anti-HSV I medication was prescribed, it should be continued according to physician recommendation. Because HAs are hydrophilic, they attract water from the surrounding tissues and further augment the soft tissue volume beyond that expected from mere implantation. The significant swelling of the vermilion in the immediate post-operative period may be camouflaged by applying flesh-toned foundation or concealer to the entire vermilion. Lipstick can then be applied to a smaller portion of the vermilion than usual so as to not exaggerate the swelling that may be present.

 

SELECTING THE RIGHT FILLER

There are a lot of difficult decisions you have to make when it comes to getting lip injections, but fortunately, picking the right filler isn’t one of them. Hyaluronic acid, in a few different forms, is both the industry standard for temporary lip injections and the only temporary lip filler approved by the FDA. 

They’re marketed under different brand names – Restylane Silk, Belotero, Juvederm – but they’re all made from the same molecule, which is hyaluronic acid, as you may already know, naturally occurs in skin and is a top ingredient in hydrating skin-care products, since it plumps skin by capturing and holding onto water. Picking which of the formulas is best for you is really up to your doctor. Hyaluronic acid is not only the best option, but the only option for those new to the world of injections, since it will dissolve on its own and is well-tolerated, since it’s already in your body. There are irreversible fillers and implants, but those are not for beginners. 

PAIN MANAGEMENT

Lips are one of the more uncomfortable places to inject filler. We have a lot of nerves in our lips, so I can do a combination of topical numbing cream and, sometimes, injectable numbing medications, so patients are comfortable. However, many of the H.A. injectables come with lidocaine (a numbing pain reliever) built right in, so some doctors opt out of additional measures. One, or a combination of the above pain-reducing options, will normally temper the pain of the actual procedure, but you’re likely to experience pain later, since the skin is being stretched. The pain as mild to moderate and notes that it can last for a few days.

SIDE EFFECTS

Any time there is a needle crossing the skin, there is a risk. Bruising, swelling, and pain – all of which can last up to days and in rare cases, even weeks – may occur. There is also the risk of infection. Naturally, this makes it very important to check in with your doctor post-treatment, especially if you’re feeling nervous about side effects.

While hyaluronic acid is a naturally occurring substance in your body, you can still have an allergic reaction to H.A. injectables, since there are often inactive ingredients (like carrying agents) and pain-reducing ingredients (like lidocaine) in the formula. Those prone to allergies or are just plain nervous can do a patch test on their forearm a few days before the procedure to be sure they won’t have an adverse reaction.

Injecting the lips can prompt cold sores for those who are prone to them, so he normally pretreats those patients with a round of anti-viral medication, like Valtrex.

There are also less common side effects that are important to consider. More rare side effects include nodules or palpable material within the lips – basically bumps of H.A. that don’t settle or feel natural. Extremely rarely, lip filler can be introduced into a blood vessel in the lip, which can have more significant consequences if not dealt with immediately and appropriately.

WHAT TO EXPECT

One of the great things about lip injections is that the results are instantaneous, so you’ll leave the office with fairly accurate (albeit swollen) results. For the first 24 to 48 hours, the filler is malleable and your skin is prone to swelling, which means be gentle! This is noted as the time that your injections need to “settle.” No facials, yoga, or exercise is recommended, which can alter the placement of the filler and increase swelling and bruising.

Lips often swell for one to three days after treatment, but this is highly variable and some patients will experience no swelling and some will have more dramatic swelling that will take longer to subside. Bruising can last approximately one week, but can be covered with makeup or lipstick, as needed. Some doctors will offer to treat more significant bruising with a laser treatment if necessary.

While the average length of time H.A. fillers will last is about six months, it varies for everyone, from around three months to a year.  H.A. lasts different lengths, depending on where you put it and how active that body part is. I find that if the labelling says six to 12 months, [patients] normally come back every three to six months.

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