Non Invasive Facial Rejuvenation / Fillers / Microneedling

Facial rejuvenation is any cosmetic or medical procedure used to increase or restore the appearance of a younger age to the human face. The specific term, however, refers to a set of surgical procedures  restore facial geometry and skin texture to a more youthful attractive state.  These procedures are usually successful and in some cases achieve striking results. Examples of facial rejuvenation treatments are Fractional, Radio-frequency and Infrared (Affirm, Refirm, Thermage) devices. These  non-invasive procedures stimulate the body’s own regenerative process of building new collagen and tighten the skin.
The old adage “No pain, no gain” may be applied to these non-invasive techniques; the longevity of treatments which do not disrupt, or burn the skin are often less than desirable.
We are excited to introduce Precision Tx laser treatment of lax neck skin. Using a specially designed fiber Laser energy is introduced from beneath the skin to tighten the neck as well as thickening and smoothing the skin. Previously difficult or impossible to accomplish with a surgical neck lift Precision Tx allows us to reliably correct this troublesome condition by tightening the skin and increasing collagen.
Microneedling is an effective, straight forward procedure which results in modest but noticeable results. Multiple micro needle holes are placed in the skin which induce new collagen formation and smoothening during healing. It helps the penetration of topical Vit C and Hyaluronic Acid to produce results similar to chemical peels, Fraxel Laser and RF treatments like Velashape, Thermage E-matrix with minimal discomfort, downtime and cost. Our staff will perform the first treatment and instruct you on how to continue treatments at home every six weeks.

Facial Fillers
With increased technology, chemists have developed longer lasting Hyaluronic Acid injectables. Restylane, Perlane and Juvederm are appropriate for medium depth lines around the mouth, eyelids, cheeks and to fill the lips. Smoker’s fine lip lines can be smoothed out as well as the corners of the mouth. This will turn up the corners to diminish a sad, drooping appearance. Radiesse, similar to Hydroxyapetite, the major constituant of bony tissues, can correct the smile lines from the mouth to the nose, the chin and between the brows, for over one year when combined with Botox in these areas. These products are relatively allergy free. Immediate results are noted with mild swelling which subsides overnight. Occasional bruising can be camouflaged with leg and body cover cream. You will look better that same evening. We have expanded the use of Radiesse and Sculptra to build up the hollows below the eyelids, cheek bones, jawline, temples and outer brows.  Careful injection into the eyelids will lift the brows, fill out the lids and prevent the need for skin excision in mild cases of lid skin excess. This enlargement will last up to two years. Always keep in mind that an additional filling session at one to four months may be necessary to maintain long term results. These fillers stimulate your own collagen production improve the quality and appearance of the skin.  This effect begins a month after injection and lasts up to two years. Please check with our staff one week in advance to ensure we have your
 choice available.

Permanent Fillers
This appealing group of procedures can give a permanent correction to the deeper folds surrounding the nose, mouth, lips, and between the brows. Cheek bones, the chin
as well as the outer upper brow/eyelid can be augmented. Several different implant options are available including grafting of skin from an existing scar, facelift, eyelid or 
tummy tuck, otherwise discarded skin. Autologous tissue grafting (fat) continues to render the most long lasting natural 
appearing results. Silicone, Polymethylmethacrylate, Latex, Gortex and Alloderm have been used successfully to yield permanent correction of these areas, albeit with higher
 complication rates and occaisional palpability and extrusion. We are very excited about the re-introduction of Bellafill. This permanent filler is an excellent choice for those seeking long term correction of laugh lines, hollows below the eyelids and creases around the corners of the mouth. We can inject this gel to enhance the lips as well as augment the cheek bones, eybrows and
 the jawline. Acne scars can be improved with long lasting results. Careful consideration of long term changes in facial anatomy must be made in planning the location and amount of correction. Facial tissues may droop leaving these permanent bulges in inappropriate locations. Conservative correction with follow up sessions obviate this potential undesireable result.

Those Juicy Lips! 
Lip augmentation has become very popular. Fullnes of the lips is not only sensual but gives a more youthful appearance. Lips can be made fuller with injections or implants. We have several options
to enhance the upper, lower or both lips exist. Injectable fillers including Juvaderm, Restylane, and Cymetra last from several months to over a year. Moderate swelling is detected for several days after
injection. Fat injections taken from the waist or thighs can give subtle but permanent enhancement. Marked swelling associated with this procedure can be diminished by injection of small amounts of fat.
 Alloderm (human collagen) or temporal fascia can be inserted into the lips through small incisions inside the mouth to achieve permanent enhancement. Contact us to arrange for a consultation to help to decide which option is best for you.
Our approach to lip aesthetics has become more sophisticated. Filling and shaping the lips in the appropriate areas will give a more attractive and pouty appearance than just enlargement alone. We can fill one or both lips, central and outer areas, depending on the shape of your lips and the look that you like. Restylane and Juvaderm are the most common fillers used today. The results can last up to 6 months. Fat suctioned from your waist or hips, injected into your lips, may last longer, and in some cases, fat injections result in permanent augmentation. Artefill a permanent injectable gel of Methylmethacrylate microshperes produces long lasting lip enhancement. Caution must be exercised as long these fillers can clump and produce lumps in the lips. The placement of Alloderm or synthetic implants is also an option for more permanent lip enhancement. Studying your lips and the photos of others helps us to shape your lips in the most desirable way. The various options and expected results will be reviewed during your consultation.

“The Thread Lift” procedure incorporates fine polypropylene barbed sutures inserted through long needles from the scalp.  Marketed as a less invasive technique for face and brow lifting our experience has shown that results usually last less than one year. This is a useful technique when used to suspend the face and brow tissues once dissected and elevated in a face or brow lift.

Lasers and Dermabrasion:
Lasers which concentrate light energy are used to selectively burn the outer layers of skin, stimulate collagen synthesis thereby causing contraction, smoothing and lightening of the skin.  Dermabrasion achieves a similar resurfacing by sanding off the superficial layers of skin. Long lasting improvement is obtained for eyelid, forehead and facial wrinkles and lines.  Dermabrasion is best suited for upper lip lines, acne and traumatic scars.  Depending on the intensity of the resurfacing oozing can last, for several days, redness for one to two months. IPL or intense pulsed light can even out blotchy brown spots and irregular skin tones. These superficial treatments are relatively safe, inexpensive and pain free usually require multiple sessions. Avoiding sun exposure is important after any of these peels, resurfacing or Retinoic acid cream use. The pink response can be camouflaged with leg and body concealer after a few days.

Botox and Dysport have become the most popular and most studied cosmetic injectable procedures.  We are now able to smooth crow’s feet, glabellar H’s and transverse forehead lines with one treatment. Results take effect within days, typically last 3-4 months. If treated regularly these lines will eventually fade. Injecting these neuromuscular modulators has become common place and apparently straightforward.  In-numerous patients enjoying good results and lack of side effects have become comfortable with these injections, usually 3-4 per side.  Side effects if not experienced in the past will usually not occur. Adverse events are different and often disregarded by patients and physicians.  These include falling or ptosis of the brow and eyelids due to local dispersion of the product. Despite multiple treatments a subsequent injection can cause these disturbing albeit temporary events. I employ several techniques designed to diminish the risk of these undesirable results and adhere to The Manufacturer’s recommendations to avoid injection 2cm above the brow and onto the eyelids proper.  Fortunately eyelid ptosis being rare, typically resolves  in two weeks and is improved with prescription eye drops. The more common sided effects of headaches, pain and bruising at the injection site are successfully treated with Tylenol.  More perplexing side effects such as malaise, shortness of breath, double vision, difficulty focusing, upper respiratory symptoms and muscular weakness are also temporary and resolve spontaneously.   One patient suffered an anxiety attack and perceived difficulty in focusing immediately after injection. Any patient suffering from a neuro-muscular disorder should advise their physician prior to injection.





Copyright © 2011, Luis A. Cenedese, M.D. F.A.C.S., Beaute des Arts Institute. All rights reserved.
30 Central Park South, Suite 1 C-D, New York, NY 10019 (212)371-0468