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Archive for March, 2009



I have the utmost respect for our capitalistic society.  Competition works to create better products, higher standards and a better society as a whole.  That is except in cosmetic medicine.  All plastic surgeons at some point in their career start to see patients that are unhappy with their cosmetic procedure that was performed elsewhere.  What [...]

Vi Peel Day 5

I must admit I’ve never been able to watch a peel this closely.  Yesterday, day 4 brought continued peeling but significantly less.  With heavy moisturizer use my wife was able to keep is under control.
Today the peeling has, for the most part, stopped.  Except for a small area around the chin.  With the peeling stopping [...]

Vi peel day 3

So day three brings more peeling.  My wife said that in the shower this morning more of her face peeled off.   Large sheets of thick epidermis found their way to the waste treatment facility.  This is good  because the Vi Peel is working.  She used significant amounts of moisturizer to keep the peeling throughout the [...]

Vi Peel Day 2

So two days ago I tried the Vi peel on my wife.  I strongly believe in trying out product on myself, wife or staff before my patients.  This gives us an accurate assesment of the product and allows us to see if the product does what is advertised.
When applying the peel my wife said it did [...]

SMAS Plication vs Removal in Facelifts

What an intriguing title for a blog, isn’t it?  Makes you want to dive right in…to bed and fall asleep.
Yes, I know, but it’s probably the most important subject when discussing a facelift – to keep fat or remove it.
The SMAS or superficial muscular aponeurotic system is the fancy acronym given to the deeper tissue [...]

Why the Midface Lift is Necessary

As we age the effects of sun damage, gravity and genetic aging act out their cruel escapades on the face.  This is most evident in the lower lid/cheek region.  As the cheek ages its fat, called the festoon, moves inferiorly and medially toward the nose.  This accentuates the nasolabial or cheek fold.  Although dermal fillers [...]

Aging of the lower eyelids can occur in different ways:

skin wrinkling
lid bulging, or
drooping of the lid

The approach to surgical correction than depends on not only the evaluation of the lower lid but also of the cheek region.  Typically younger patients can have lower lid bulging without excess skin wrinkling.
As aging and sun damage occurs [...]

Why We Should All Use Tretinoin

Unless you live in a cave the sun’s UV rays are going to damage your skin.  These UV rays damage skin cell proteins, internal structures and even the DNA.
Now, our bodies are pretty smart, so many of these cells are lost as we shed skin and our immune system takes care of most of the rest.  But unfortunately some [...]

Facial Fat Adds Youth

It’s ironic that as we strive to stay fit and keep those extra pounds off for our health it can be detrimental to facial aging.  After all youth is fat; just look at any baby.  As we age we tend to lose fat especially in our faces.  So how do we keep that facial fullness and a healthy body.  Add the [...]

Included in the March-April issue of Archives of Facial Plastic Surgery is a medical study on the safety of the Botox alternative/wrinkle relaxer Dysport.  The drug was evaluated for its use on moderate to severe forehead wrinkles (or glabeller lines).  The results of the study sound fairly optimistic.
FDA approval has not yet been granted for [...]



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