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Question:
I am male, 26 years old, and would like chin augmentation. How long do the effects of this surgery last? What do you use to augment the chin, an implant or fat transfer?

Answer:
At 26 years old I would suggest a permanent surgical chin implant.  I prefer the use of silastic, which is hardened silicone, chin implants for chin augmentation.  The implant comes in various shapes and sizes to fit your individual facial needs.  The implant is not recognized as foreign by your body so that implant extrusion is extremely rare.

I perform cheek implants by placing the implant through an incision that I create inside the mouth.  The implant must be placed into a fairly tight pocket that is created beneath all of the skin, muscle, and fat of the cheek in order to prevent shifting of the implant.  I also offer the injection of dermal fillers such as, Perlane and Radiesse so that you can see what effects permanent cheek implants will have on your face.   The cheek implant procedure can be performed under local anesthesia, however, I prefer a mild sedative or IV sedation when performing the cheek implant procedure for your comfort.

Posted by Dr. Philip Schoenfeld

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Question:
Over the years, the fold that runs from the edge of my nose down to my mouth on both sides looks like it is sagging. I wonder if I can get this repaired without surgery. Is there something that could be injected into my cheeks to fill it out? Is anything like that permanent?

Answer:
There are numerous fillers available to help decrease the depth and appearance of the nasolabial fold, the fold that runs from the side of the nose to the corner of the mouth. I use many injectable dermal fillers for this area including Restylane and Juvederm, however, I like Perlane and Radiesse in these areas when the skin is a bit thicker or the nasolabial groove is deeper. I am not a big fan of permanent filler in this area other than autologous fat injections as I feel that your face will continue to age and permanent artificial fillers may not be appropriate in the areas in which they are injected.

Posted by Dr. Philip Schoenfeld

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Question:
There seem to be many different procedures referred to as mini facelifts. What are the available options for less invasive/mini facelift procedures and are some better than others?

Answer:
You are correct in your observations with regards to the number of procedures referred to as mini facelifts.  I know of two approaches that I consider mini facelift surgery. 

The first and most popularized is also called a MACS lift.  The MACS lift procedure elevates the skin of the face and then uses permanent sutures to elevate the tissue layer beneath the skin to reposition the skin of the face in an upward direction, thus, decreasing facial wrinkling and jowling. 

The second approach pulls this same tissue layer beneath the skin after the tissue layer is dissected free from the remainder of the face.  The mini facelift is appropriate for younger individuals who have laxity of the jowls and lower face.  The mini facelift is not very effective for moderate or significant neck skin laxity.  The mini facelift does have a more rapid recovery than a full facelift procedure.

Posted by Dr. Philip Schoenfeld

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Question:
Does the facelift improve nasolabial folds and marionette lines.

Answer:
The face lift does improve nasolabial folds and marionette lines. A deep plane face lift will address the nasolabial folds best, but many surgeons will also place fat into the nasolabial folds to decrease the appearance of these lines. The marionette lines will decrease by elevating the jowls during the face lift.

Posted by Dr. Philip Schoenfeld

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Question:
What are some of the common complications associated with injectable fillers?

Answer:
Injectable fillers are extremely safe. Having said that, all procedures come with potential complications. Some of these potential complications are not unique and involve all of the injectable fillers. Pain, bruising, bleeding, infection, and transient redness are a few. Skin irregularities, vascular injection with resultant areas of skin sloughing, allergic reactions, and foreign body reactions which are much less common potential complications all dermal fillers but seen more frequently with permanent dermal fillers.

Posted by Dr. Philip Schoenfeld

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Question:
Can you explain what the SMAS is and what it means to tighten them during a facelift?

Answer:
Your question with regards to the SMAS and face lift surgery is a good one. The SMAS (subcutaneous aponuerotic fascial system) is a very strong yet thin tissue layer that exists beneath the fat of the facial skin. The SMAS is the layer of the face that is pulled tightly in order to elevate the jowls, tighten the neck, and alleviate the naso labial fold skin during a face lift. The skin of the face is merely re draped over the newly repositioned SMAS layer. By using the SMAS layer to lift the face, your surgeon can give you an extremely natural appearing face lift and avoid the unnatural appearing facial features that have become so stigmatic of a face lift procedure. Also, the degree of improvement and the longevity of the results are significantly improved by lifting the SMAS layer and redraping the skin during the face lift.

Posted by Dr. Philip Schoenfeld

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Question:
I have started using birth control pills to regulate my acne problem. I’m hoping that a dermabrasion procedure will get rid of old scars. Will birth control pills have an effect on dermabrasion, or vice versa?

Answer:
Your question is really two questions.  First, microdermabrasion will help in reducing your outbreaks of acne by cleansing your pores and enabling topical medications to penetrate much more deeply into the blocked pores causing the acne break outs.  Birth control pills can lead to hypersensitive skin and even hyperpigmentation of the skin so before you undergo any new microdermabrasion procedures, please alert your esthetician that you are using oral contraceptives.

Posted by Dr. Philip Schoenfeld

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Question:
Are different peels designed to repair certain types of scarring?

Answer:
Superficial chemical peels are really not designed to treat facial scarring. Chemical peels can help in decreasing the appearance of facial scars by tightening the skin of the face and thereby tightening and lightening up the appearance of the scar but this is more of a positive side effect of the chemical peel rather than the objective of using chemical peels for scar reduction. Deeper chemical peels can, however, significantly reduce the appearance of acne scars in the proper individuals.

Posted by Dr. Philip Schoenfeld

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