Non-Surgical Butt Augmentations with Sculptra

How To Get A Bigger Butt

Over the past 10 years the number of legitimate  butt implants has increased over 140% according to the American Society of Plastic Surgeons.  The number of fat grafting buttock lifts (Brazilian Butt Lift) is climbing at similar rate to implants.  Again, the Kardashian's influence over society.  

On the one hand, they really have opened the medical aesthetic market and probably saved it from collapse (there's an implant joke in here somewhere).  They do offer a lot of information to the public (although they manipulate the information they give so always remember–unless you are talking to an ACTUAL expert, information about plastic surgery, injectables, or skincare has no validity or reliability!)  They are however… idiots, for lack of a better word and are grossly miseducating the public on procedures. I'm not sure if I owe them royalties or not, but hopefully people who are planning on booking appointments in my office will have a better understanding of the procedures I offer.

There are 3 legal, safe, FDA-approved options to achieve that "Brazilian Butt Lift" (I mean BESIDES squats all day long).  

Butt Implants

Personally, I don't find this route to be the most aesthetically pleasing, and only know ONE person who has had a butt implant and been extremely happy and had no complications with this procedure (and this particular person does not have the most natural looking result, but they are happy with it!).  There can be extreme complications with putting a silicone implant in an area that is either in motion or bearing large amounts of weight (or both). Recovery is extreme and painful, and should there be a complication (this surgery has a very high infection rate) you're looking at up to 6 months out of work.   Even with a smooth procedure, long term complications such as the development of infection and shifting of the implant are possible.  

Surgical Butt Implants should be performed by a Board Certified Plastic Surgeon.  Implants can be different sizes, shapes, and put in different places to achieve the aesthetic outcome the patient is looking for.  Be sure to discuss your expectations for projection, size, and proportion to other areas of your body (like hips!).  

Fat Transfer

In order to transfer fat, you must HAVE fat to transfer.  Plan on needing to be 10-20 lbs over the appropriate weight for your body prior to transfer (your Board Certified Plastic Surgeon will tell you exactly what you need to weigh for the treatment). This is a hard concept for a lot of my clients to understand. You have to actually be able to grab the fat away from the vital organs that it protects. Skin is not fat. It can be just as hard for some people to gain weight as it is for others to loose it. If you have a hard time gaining weight, a fat transfer may be a waste of money for you.  

Immediately post transfer, expect a dramatic result, but do not expect that as the final result. Remember, not all the fat will graft, and there is a signfiant amount of swelling post transfer. It is important not to overfill the buttocks when doing a transfer, even though you might think you should to get more fat to graft. The increased pressure from overfilled, stretched skin may actually cause the fat to die. Recovery time is minimal, and you should follow any post-treatment instructions given to you by your plastic surgeon.  

I do think this is a great option (I personally do not do ANY surgical procedures in my office, but have seen MANY excellent fat transfers–I especially see great results for Brazilian Butt-Lifts in Miami! If this is something that interests you, I'm happy to pass along a great board-certified MD–the experience of the Dr. matters! Do not do this procedure with a general surgeon! 

Non-Surgical Options 

This is what I have to offer to the mix. I have been injecting Sculptra for it's intended FDA-approved use for about 8 years, and over the past 2 years, I've been doing TONS of it. I've always found it to be one of the best investments anyone can make in their skin, but it the hardest treatment to explain in terms of investment value. Sculptra is not immediate, it takes multiple vials, and multiple treatments which correlate to the amount of collagen loss the patient had to start, and what their expectations are. Although it is a commitment of time and money upfront, it is much more cost effective and natural looking than fillers. My mother has had sculptra treatments, and personally I would love to be injected with sculptra (I can't inject myself). If you are a yoga person or a runner, sculptra is FOR YOU!

Anyways, back to butts…

Sculptra Aesthetic is made with biocompatible, biodegradable, synthetic material called poly-L-lactic acid, which is gradually and naturally absorbed by the body and helps to rebuild lost collagen through a series of treatments. The specialist injects treatment within the deep dermis, where strands of collagen support your skin’s structure. For significant volume increase, a session of sculptra for the buttocks is 6-10vials, and 2-3 treatments 6-8weeks apart are required. The low-end cost for one treatment is about $6,000 and can be up to $12,000 PER TREATMENT.  

This procudure is certainly not affordable to the average person, BUT this product doesn't need to be done singularly. For patients who have previously had a fat transfer, and need more defined sculpting done in certain areas, this can be a great adjunct treatment.  If there is a small area of indentation, assymetry, or concavity that bothers you, sculptra might be a cost-effective option.  

Combination Therapy For Butt Augmentation 

Sculptra should be discussed with anyone who is planning on undergoing a fat transfer prior to thier surgical appointment. Just like any other aesthetic investment, managing expectations are vital, and although the expectations of the treatment are explained and discussed during Informed Consent, the patient should also have an idea of what follow up treatments they may require and their cost.  

As of publication of this post, these are the ONLY safe, FDA-approved (but still considered off-label) procedures you should even CONSIDER undergoing. Yes, all of these options are expensive, but if you cut costs and receive something other than these 3 options, there is a high chance you will have severe complications such as necrosis (tissue death), limb loss, or even ACTUAL death.  But first you'll pay up in hospital fees, because complications of elective, non-FDA approved procedures–insurance will not be covering those costs.  PLEASE do not put anything in your body that isn't safe!  

How to Get Rid of Cellulite

Guess what!  A variation of this procedure gets rid of cellulite.  Treatments for cellulite have traditionally been disappointing for the consumer, but this treatment is awesome!  Stay tuned for more blog posts on sculptra for cellulite reduction!  

with BlogPad Pro

High School Reunion: Look Better than You Ever Have!

or at least look like your Facebook photos!

Ok, so I haven’t yet gone to any of my reunions… I run into people from my High School every now and again (you know… While I’m Botoxing them in my office….).  It is always great to catch up with the people who knew you when… Unless you don’t like them.  Then it’s great to look better then they do.

As as for the ex-boyfriend factor… Personally, I ran into one of my high school ex’s recently… Ehhhh what was I thinking?!?!?!!!!!!  (Dad, you were right about all my boyfriends!).  Even so, it can’t hurt to look uber attractive at a big reunion.  I just picture Romy and Michelle… Inventing post-it notes.  Ugh… And that AWEFUL football player.  Insert theme music:  time after time.  Love that song.  Sorry… I digress!

A reunion is as good a reason as any to want to look good.  Feeling good about yourself physically boosts your positive self-image and brings out an all-around better you!  And what could be more attractive then that?

So get pumped, start that diet, buy some AMahZing shoes, check out my video, and make them jealous.  Or just have fun… 🙂

VBlog Reunion

Restylane Silk for Aging Lips

  

A New Addition to the Restylane Family

Restylane Silk is now FDA approved for submucosal implantation for lip augmentation and dermal implantation for correction of perioral rhytids (smoker’s lines) and it is currently available on the US market.   This product provides a subtle solution to aging signs around the lip and mouth area.  It’s greatest quality is subtle enhancement; your lips will not look “done” or “artificial.”  

  

Hyaluronic Acid for Lip Augmentation

Although Restylane Silk is the first product to be FDA approved for lips, we have been using other products for years.  Juvederm and Restylane are commonly used to augment the lips in an “off-label” treatment (FDA approval costs millions of dollars and takes many years.  These products are all very safe to inject in the lips by a trained professional).  

These products, along with Belotero, are all in the hyaluronic acid family.  Hyaluronic acid (HA) is a sugar your body naturally produces; these products are synthetic gels.  Because your body naturally makes this sugar, the chances of being allergic are almost zero.  This family of products IS reversible, if for any reason, you are unhappy with the results.

The molecular structure of Silk is smaller, and the product flows to where it is needed.  It doesn’t over bulk, and is a perfect finishing agent for fine lines.  

Which product is best is really dependent on who the client is, and what result they want.  If you are looking for subtle and natural lip augmentation, Restylane Silk is the product for you!  

My Experience 

At the beginning of March, I was told this product would be available and I was so excited to try it.  Lip augmentation has always been a specialty of mine, and I was told “I would love this product for the vermillion border” (where the color changes from pink to skin-toned).  

 

I was excited to try it, but my idea of an “ideal” client for this product was way off!  I first tried it on a 24 year-old patient.  She (and I for that matter) were not impressed, it looked like nothing was done.  Then I realized I was supposed to be using it for a whole different population of client.  The older patient who didn’t want to look like anything was done!   Oops… Probably should have read the email about the product FIRST. 

So then I tried it on an employee in her 50’s.  The results blew me away!  Like always, the pictures do the results no justice.   

The final result is very natural looking.  It is hard to see from the picture, but the before has a defined ridge above the lip, which is SO much improved with the Silk injections.  (The spray tan and make-up can throw you off in the after pictures.) 

The technique used to inject this product is VERY different than previous products used to treat lips.  If incorrectly injected, the product will not give you the best results, cause swelling, and has been reported as painful by patients.  This product requires the knowledge and expertise of a skilled injector.  

I had a few clients trial the product (including my awesome mom!).  They sent me their after pictures via text.  Again, not the greatest quality pictures, but every client was extremely happy with the results and gave great feedback.  (Thank you ladies!). 

    

Final Thoughts

Because the typical Silk client is older, make sure you consider timing in booking an appointment for this procedure.  Like any injectable product, swelling and bruising are always a possibility.  You want to avoid icing post-procedure to allow the product to smoothly integrate into the tissue.  If you have a big meeting at work the next day, you probably should reschedule (…the meeting OBVIOUSLY!  Who wants to wait for such amazing results!  Plus, then the meeting will go better with your new confidence!).   

How long will a bruise last?  Remember everyone is different.  Some people don’t bruise at all.  Check out my blog on bruising info.  

Other Uses

I read Silk was also a fabulous filler to use in the glabellar crease… Blog post coming soon!   

For questions or to book an appointment with me, call my office at 781-235-4957.  You can also book online at http://www.LauraKimberleyRN.com.  

Video Blog: Tear Trough Augmentation

Check out my video blog on YouTube: 

One of my favorite procedures to do since the introduction of Belotero Balance in the United States last October.

The tear trough is a grooved demarcation where the cheek skin meets the much thinner and highly vascular eye skin.  Because of the anatomy of this area, a thinner hyaluronic acid like Belotero is the perfect product (Belotero: The Buzz.).  It does not last as long as the more viscous hyaluronic acids, but it also has fewer complications.

Treatments in the middle third of the face, which contains the eyes, nose, and cheeks, require an aesthetic eye and advanced knowledge of facial anatomy.  Filling the tear trough area often requires cheek augmentation as well in order to look natural.  The cheeks can require a large amount of product depending on the degree of volume depletion.  Make sure you discuss this with your injector prior to injections!

This is a very advanced procedure, make sure you check out before and after pictures before being injected!  Many practioners do not offer this procedure because of the advanced training and skill it requires.  When done correctly, it looks AMAZING.  I’m not even a very good iPhone photographer, and I have some great before and after’s on my Pinterest and in other blog posts:

More Belotero!.

I hope you enjoyed my video.  They are really hard to make!

Botox Injection Locations

Locations in the face where Botox can be injected.

Lighting is good, and my voice sounds normal. I think I got the hang of vBlogging.

Please share this link with your friends!

Botox 101

An introduction to Botox. What it is and what it isn’t.

Video Blogging… It Starts…

Here’s my first video blog!

Peanut Head: Volume Loss at the Temples

I’d argue the most over looked sign of aging is loss of volume in the temple. As we age, the temples lose fat and begin to narrow, shifting the balance of the face downward. Volume loss here contributes to the appearance of drooping and sagging of the cheeks and eyes (see Structural Changes in the Aging Face for other changes).  It begins as early as in your 20’s. It is most notable in athletes who have very little fat on their bodies, I’ve found especially runners.

As you can see, the area of total volume loss is pretty big when you actually look at it. In order to achieve the youthful contour of the temple, a patient will require a lot of product here. Adding filler to the temple is easy and almost painless, but deciding what filler to use can be difficult, they all have pro’s and con’s.

Juvéderm

This is usually my first choice with patients. For some reason… people tend to be nervous about filling this area! The great thing about Juvéderm is that it’s disolvable. The bad thing about Juvéderm is… you need a lot of it to fill this area, and that can be expensive. I’ve found great results by diluting the product before injection. The patient can see the result immediately. It may not last as long this way, but it is a good starting point. Most people love the result and usually step up to Sculptra when they notice they need a “refill.”

Radiesse

I personally don’t use Radiesse in the temples. It always reminds me of the scene from the Real Housewives of Beverly Hills when Adrienne Malouff’s husband injects Taylor and she has this big bump in her temple and Adrienne goes “is it supposed to look like that?” Although you get more volume with Radiesse, you also have more of a chance for lumps in this area. It’s not as smooth as Juvéderm (which is literally defined as a smooth consistency gel). It’s just not my preference, but for extreme volume lost I can see it being more cost effective.

Sculptra

I personally have had Sculptra injected into my temples. Sculptra is not a filler, but a biostimulator. Over several weeks post injection it promotes collagen production. It may take more than one treatment (usually 1-3 vials 1-3 treatments) to achieve the desired result. This is the longest lasting, and most cost effective product if you consider the longevity, but up front can be expensive. If you are the type of patient who is doing multiple fillers at a time, you should probably step up to Sculptra.

Fat Transfer

Fat injections can also be used in the temples but are only cost effective if a large amount of volume is needed for the entire face. I recommend only allowing a plastic surgeon perform this procedure (although a nurse can do it in Massachusetts). The fat is harvested from another area of the body (usually the lower back) via liposuction and transferred to areas of volume loss in the face (usually not just the temple). There is a lot of swelling and bruising with this treatment and not all the fat will graft (stay alive after transfer). It is also an expensive and invasive procedure. This being said, it can yield great results for patients who really need it.

The Procedure

Numbing cream is applied to the temple. The product selected is mixed with lidocaine and deposited on the bone until achieving desired volume. There is very little pain associated with all injectable products. Bruising isn’t typical; however, there are many vessels in this area, so it can happen. Expected cost depends on the product selected, but expect to use at least 1-2 syringes during time of treatment.

Good luck!

Sun Block and Photoprotection

Everyone should be wearing sun block. But is that enough?

Prolonged unprotected sun exposure damages cell DNA. Not only does this result in premature aging, but can also cause melanoma and other skin cancers. I am a HUGE believer in wearing sun block (and not just in your make-up… that really doesn’t count).

When Buying Sun Block

If you’re not wearing it year round (which you should be), you should replace your sun block every year. Products can break down from heat exposure and from not being stored properly. It’s worth doing. You want to make sure you’re getting the best protection you can. Check your bottle for the following:

• “Broad Spectrum” (protects from UVA and UVB light)
• SPF 30 or higher
• Zinc Oxide or Titanium Dioxide (physical blocks)

For more on sun block read It’s Sunny Out! (A Post in Honor of Sun Block).

Avoiding White Residue

I know people hate the white residue you get from zinc oxide or titanium dioxide, but these ingredients really are the best for sun protection. If you don’t like the white residue on your face, consider either buying a tinted SPF or buying a product that has a micro-ionized formula (smaller particles). I’ve found people really love SkinCeuticals Sheer Physical UV Defense SPF 50. It’s really light weight, doesn’t smell, and doesn’t leave a residue. The product retails for about $34, so it isn’t super expensive either.

C E FERULIC

While on the subject of SkinCeuticals products, and sun block, I have just started using their C E Ferulic serum. C E Ferulic contains ferulic acid, an antioxidant that doubles the synergistic benefits of C E – neutralizing free radicals, building collagen, and providing improved antioxidant protection. No other antioxidant technology has been shown to deliver comparable levels of photoprotection. This product has won multiple awards including:

• Allure Best of Beauty Three-Time Award Winner Category: Best of Skin Care – Serum
  
• InStyle Editor’s Pick – 2011 Best Beauty Buy Best Antioxidant Serum
  
• NewBeauty – Beauty Choice Award The Best Anti-Aging Antioxidant Product
  

Although retinol (Every Woman Should Own A Retinol Product.) and sun block are the only topical products proven to prevent fine lines and wrinkles, I think a good anti-oxidant is almost equally important. For those of you who prefer not to use a retinoid in the summer months, C E Ferulic is definitely a good product to add to your beauty routing; it is outstanding in conjunction with sunscreen!

**Products can break down if not stored correctly (like I said before) and pharmaceutical grade products like C E Ferulic should never be bought online. Just like it’s worth it to buy new sun block, it’s also worth the few extra dollars to know your product wasn’t exposed to extreme temperatures, tampered with, or expired. Talk to a medical aesthetician if you’re interested in learning more about C E Ferulic!

Why Is Photoprotection Important?

Photoprotection is a measure of a product’s ability to neutralize free radicals and protect against oxidative stress (which can be caused by UV rays). Oxidative stress leads to premature aging, hyperpigmentation, and loss of elasticity… my three biggest fears!

Recent Studies Reveal We May Not Be As Protected As We Think:

• People don’t apply enough sunscreen to achieve full SPF. Real-life application of an SPF 20 sunscreen yields an SPF of only 3 to 4.
• Even when applied properly, sunscreens only block 55% of free radicals.
• Considering what we now know about sunscreens, photoprotection is more important than ever.

The sun is stronger than it used to be, and protecting your skin is not an option. It’s time to add an anti-oxidant to your daily skin care regiment!

XOXO, LK

Structural Changes in the Aging Face

Wrinkles and sun spots aren’t the only things we can expect to happen to our face as we age. There are many structural changes going on below the skins surface that contribute to an aging face that most people would never have noticed when they look in the mirror.

The young face on the left is round, contoured at the cheeks, and has a sharp jaw line (oh and hair and no wrinkles). The face on the right appears narrower, sunken, and droopy.

So besides the integrity of your skin, what else has changed?

Below the Skin

Bone Structure

Let’s start at the ground level. Your bones.

Your bones are always being built up and broken down. The rate at which the bone is broken down slowly starts to exceed the rate at which the bone is being built up as you age.

Bone changes cause:

• a reduction in facial height
• Increase in facial width and depth
• The fat pad under the eye to bulge
• A change in the shape and projection of the chin

Teeth

Injury and periodontal diseases result in loss of teeth, and it’s not like when you were young and the tooth fairy came and left you a dollar and a new tooth grew in (I hear with inflation it’s like $5 now!).

Loosing teeth affects the jaw bone and the muscles which attach to the jaw bone, which can result in make the face look narrower, hollow, and concave on profile.

Taking care of your teeth is super important, and not just for that pretty smile!

Fat Compartments

Collapsing fat compartments in the cheeks and temples reduce support to the overlying skin (side note: don’t worry! These fat cells go to other places… like your hips! j/k).

Splitting the face into thirds

Upper Third

Most people miss this when they look into the mirror at their aging face, but loss of fat in the temples results in the phenomenon I like to call “peanut head, ” which is also noticeable on super athletic people.

The presence of peanut head reflects a lack of support of the outer brow, which, along with loss of subcutaneous fat in the upper lid, causes the appearance of a droopy upper brow.

Blephroplasty anyone?  (Observing Surgery: Blepharoplasty.)

Middle Third

Eye sockets become wider and longer, resulting in a bulge of the cushiony fat pad that lies underneath the eye.

The cheeks start to flatten out, and the fat from the cheek descends to create a deep nasolabial fold.

The tear trough (area where eye skin and cheek skin meet) becomes noticeable. The middle third no longer has that fluid contour. This loss of fullness and form change causes shadowing in the trough, making a person appear to have dark circles, resulting in a tired appearance (just one of the things that causes dark circles).

Angles of the nose change, giving the appearance of increased length and the tip of the nose begins to droop.

Decrease of collagen and increase in tooth display at rest cause the upper lip to lengthen. Fun Fact: the upper lip can stretch by almost 4mm as you age.

(Stolen from another site…shhhh…) Image A shows a youthful face. Look at the contouring from the eye to the cheek. As you age, it can be convex like image B, which shows the fat pad bulging, or it can be concave like image C, making the eyes look hollow. Both B and C show a flat cheek when compared to Image A.

Lower Third

With all this stuff happening in the upper portions of the face, skin sags and starts to hang in the lower third. Adding insult to injury, the angle of the jaw changes, the jaw line, becomes less defined, and the chin shortens. Excess skin droops from the jaw line from gravity and loss of elasticity. Loss of ligament support in the jaw leads to the formation of jowls.

Even with droopy skin, the lower portion of the face starts to look smaller than the upper and middle third.

advancedskinwisdom.com a

(This image was also stolen).

What are your options?

Don’t worry. There are things you can do for volume loss! They do NOT include Oil of Olay, although the new commercial on tv claims it can (they lie).

Injections

For advanced volume loss, Sculptra is really the best injectable product. This product is a biostimulator; it works by stimulating your body’s own natural collagen. Results are the most natural of all the fillers, and the product lasts 2 years. I plan on writing a lot more about Sculptra, so stay tuned!

If you aren’t mentally or financially ready to jump into Sculptra, Radiesse is a wonderful thick, volumizing filler. It is usually my product of choice for cheek augmentation, naso-labial folds, and marionette lines.

For tear troughs, I LOVE Belotero (which is made by the same company as Radiesse). Filling this area literally takes ten years off your face, but remember, it is a very advanced procedure. Stick to a friend’s referral as to who to go to; I have seen a lot of over treated troughs!

For more help with fillers, check out What Goes Where?.

Surgical

Another option is fat transfer. I have assisted in several fat transfers; it is a very interesting procedure. If you are planning on liposuction, I highly suggest inquiring about fat transfer as well.

For sagging skin around the neck and jaw line, surgery is the only real option to date.

XOXO, old LK

(I found the ‘Age My Face’ Ap… yes… there’s an ap for that!)