Tag Archives: facelift


Permalink to Thermage Is Non-Invasive Skin Tightening

Thermage Is Non-Invasive Skin Tightening

What is Thermage skin tightening and is Thermage right for you? Lately, perhaps in response to the current economic conditions, or perhaps just because people are coming to understand that in the area of cosmetic surgery we have much more to offer than just surgery, I am asked about non-invasive solutions. One particular area of concern is the problem of loose skin which is a result of aging and/or child rearing.  One of the very successful non-surgical, non-invasive procedures we offer here in Sacramento is called Thermage.

Thermage is a noninvasive radiofrequency (using radio waves) technology to tighten the skin in the face and body.  It has been cleared by the FDA since 2002 and has been used in 80 countries by more than 2500 physicians in over 500,000 procedures.  When facial aging occurs, skin sags.  One of the reasons this happens is because the skin is attached by fibrous bands to the muscle underneath. When these bands are stretched out, the skin starts to hang. Thermage delivers radiofrequency energy through the skin heating these bands. The heating causes the collagen to shrink as it heals and it and goes back to its original and normal length over several months. The final result is smoother skin with less sagging.   Thermage can be used in many areas of the body including the face, neck, arms, abdomen, hips, and thighs.  With some patients, it can also be used for cellulite control. When used in the body, with a special new larger tip, it can actually cause a reduction of several inches in diameter of the waist or legs.  It is not the same as abdominoplasty or tummy tuck, but for those who are not a candidate for abdominoplasty but have some problems with loose skin in the tummy area, it Thermage may reduce the problem significantly.

The current version of Thermage is the third and best generation of radiofrequency technology.  Previous generations delivered large burst of energy and had a reputation for being uncomfortable. The new generation has solved the discomfort problem by decreasing the energy pulse and combining it with a vibration tip and cooling, which distracts nerve fibers, preventing them from feeling discomfort.  The patient feels a warm feeling at the touch of the machine but not discomfort.

Thermage is an excellent tool and can be used for facial tightening in younger women who do not yet need a surgical procedure such a a full or mini face life, or women who have had a facelift that has begun to loosen over time but are not yet candidates for another procedure.  It is the only solution in women with moderately loose skin in the arms legs and abdomen. In the past, these patients were not candidates for either liposuction or skin removal procedures but now they can be treated with Thermage.  It also works very well for women who have a slight excess in skin and fat but do not want liposuction.

Call our office to learn more about how Thermage skin tightening may be the non-surgical, non-invasive solution for your needs.


Permalink to Facelift or Fillers?

Facelift or Fillers?

“Facelift or filler, What do you think Dr. K?”face lift questions

Facelift or filler, seems like an easy question. For the moment we will not address brow lifts and eyelid lifts. But the process to get the answer is fairly complicated.  As always it goes back to your anatomy.  If you look at your face there are many ways to diagram it or separate the parts.  One way is by skin adherence and mobility.  Around the mouth skin is adherent to the muscle, there isn’t much fat and there’s a lot of emotion in this area.  The rest of the face, cheek, jowels, and neck have a layer of fat between the skin and muscle and less adherence with less motion when we eat, talk or laugh.  But it does have more of a tendency to sag as we get older.  In addition one of the unfortunate aspects of aging for many people is a loss of facial fat.  No one really knows why it goes away.  It just does.  It seems to be related to declining hormone levels but all that still needs to be worked out.  Look at the photos of people in college, in mid life, and then when their old.  The loss of fat, the gaunt look is quite striking.  As an easy visual, think of Al Pacino in the Godfather and then again in his latest movie.

So we have two areas of the face by these criteria.  The central area just above and below the lips creates wrinkles from use and the lips themselves shrink.  Does lifting and pulling help any of this?  No.  What’s worse an ill-advised attempt at improving the lips by pulling (face lift) gives the widened stretched lizard lips sometimes seen in aging movie stars on late-night talk shows.  Lipstick lines, nasolabial folds, and the lips themselves are perfect for fillers which plump up and spackled these lines.  One exception to this rule is the tear trough area just under the eyes which can present as a darker circle but not a bank or a bulge but a hollow.  This area also responds very well to fillers.

On the other hand if there are jowls, multiple cheek wrinkles, and heavy nasolabial folds and neck issues, fat, hanging skin, muscle bands, then a facelift is the only way to go.  Fillers may help slightly with the nasolabial folds but by themselves cannot lift the jowls and neck.

Now that we know what a filler does, what is it?  There are many different kinds ranging from collagen to silicon to fat.  The most commonly used ones now are hyaluronic acid such as Juvederm and Restylane.  This is a natural component of our skin and was formerly obtained from rooster combs but is now available by being made by bacteria.  This substance which looks like a clear jelly is injected through a small syringe with a very small needle.  Depending upon the area, this can be done with no anesthesia, topical anesthesia or nerve blocks like a dentist.

Facelift or filler?  Look at the mirror what do you see?  Then see if your doctor agrees.

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  • Andrew Kaczynski, MD

  • Advanced Concepts in Plastic Surgery
  • 77 Cadillac Drive
  • Sacramento, CA, 95825
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  • Granite Bay, CA 95746
  • (916) 925-5522